Yesterday, Today and Tomorrow (New Library of Psychoanalysis)

Yesterday,Today and Tomorrow

Yesterday, Today and Tomorrow presents a selection of papers written by Hanna Segal.The collection introduces the reader to a wide spectrum of insights into psychoanalysis, ranging from current thoughts on the nature of dreaming to new ideas about vision and disillusionment Her long interest in factors affecting war is pursued in her examination of the psychotic factors, symbolic significance and psychological impact of the events of September 11, and the ensuing war on Iraq. The second half of the book discusses Segal’s presentations to conferences and symposia from 1969–2000, this material is split into six parts: • • • • • •

Models of the mind and mental processes Psychoanalytic technique Segal on Klein Segal on Bion Envy and narcissism Interviews

Yesterday,Today and Tomorrow is a masterly contribution to the field. Segal’s clarity of thought and striking clinical illustrations make the book accessible to those new to the field as well as those acquainted with her seminal work. Hanna Segal is an internationally renowned psychoanalyst. She has served as President of the British Psychoanalytical Society, Vice President of the International Psychoanalytical Association and Freud Professor of Psychoanalysis at the University of London. Her earlier publications include The Work of Hanna Segal, Dream Phantasy and Art and Psychoanalysis, Literature and War.

THE NEW LIBRARY OF PSYCHOANALYSIS General Editor Dana Birksted-Breen The New Library of Psychoanalysis was launched in 1987 in association with the Institute of Psychoanalysis, London. It took over from the International Psychoanalytical Library, which published many of the early translations of the works of Freud and the writings of most of the leading British and Continental psychoanalysts. The purpose of the New Library of Psychoanalysis is to facilitate a greater and more widespread appreciation of psychoanalysis and to provide a forum for increasing mutual understanding between psychoanalysts and those working in other disciplines such as the social sciences, medicine, philosophy, history, linguistics, literature and the arts. It aims to represent different trends both in British psychoanalysis and in psychoanalysis generally. The New Library of Psychoanalysis is well placed to make available to the English-speaking world psychoanalytic writings from other European countries and to increase the interchange of ideas between British and American psychoanalysts. The Institute, together with the British Psychoanalytical Society, runs a low-fee psychoanalytic clinic, organizes lectures and scientific events concerned with psychoanalysis and publishes the International Journal of Psychoanalysis. It also runs the only UK training course in psychoanalysis that leads to membership of the International Psychoanalytical Association – the body which preserves internationally agreed standards of training, of professional entry, and of professional ethics and practice for psychoanalysis as initiated and developed by Sigmund Freud. Distinguished members of the Institute have included Michael Balint, Wilfred Bion, Ronald Fairbairn, Anna Freud, Ernest Jones, Melanie Klein, John Rickman and Donald Winnicott. Previous General Editors include David Tuckett, Elizabeth Spillius and Susan Budd. Previous and current Members of the Advisory Board include Christopher Bollas, Ronald Britton, Catalina Bronstein, Donald Campbell, Sara Flanders, Stephen Grosz, John Keene, Eglé Laufer, Juliet Mitchell, Michael Parsons, Rosine Jozef Perelberg, Richard Rusbridger, David Taylor and Mary Target.

ALSO IN THIS SERIES Impasse and Interpretation Herbert Rosenfeld Psychoanalysis and Discourse Patrick Mahony The Suppressed Madness of Sane Men Marion Milner The Riddle of Freud Estelle Roith Thinking, Feeling, and Being Ignacio Matte-Blanco The Theatre of the Dream Salomon Resnik Melanie Klein Today:Volume 1, Mainly Theory Edited by Elizabeth Bott Spillius Melanie Klein Today:Volume 2, Mainly Practice Edited by Elizabeth Bott Spillius Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph Edited by Michael Feldman and Elizabeth Bott Spillius About Children and Children-No-Longer: Collected Papers 1942–80 Paula Heimann. Edited by Margret Tonnesmann The Freud–Klein Controversies 1941–45 Edited by Pearl King and Riccardo Steiner Dream, Phantasy and Art Hanna Segal Psychic Experience and Problems of Technique Harold Stewart Clinical Lectures on Klein and Bion Edited by Robin Anderson From Fetus to Child Alessandra Piontelli A Psychoanalytic Theory of Infantile Experience: Conceptual and Clinical Reflections E Gaddini. Edited by Adam Limentani The Dream Discourse Today Edited and introduced by Sara Flanders The Gender Conundrum: Contemporary Psychoanalytic Perspectives on Femininity and Masculinity Edited and introduced by Dana Breen Psychic Retreats John Steiner The Taming of Solitude: Separation Anxiety in Psychoanalysis Jean-Michel Quinodoz Unconscious Logic:An Introduction to Matte-Blanco’s Bi-logic and Its Uses Eric Rayner Understanding Mental Objects Meir Perlow Life, Sex and Death: Selected Writings of William Gillespie Edited and introduced by Michael Sinason What Do Psychoanalysts Want? The Problem of Aims in Psychoanalytic Therapy Joseph Sandler and Anna Ursula Dreher Michael Balint: Object Relations, Pure and Applied Harold Stewart Hope:A Shield in the Economy of Borderline States Anna Potamianou Psychoanalysis, Literature and War: Papers 1972–1995 Hanna Segal Emotional Vertigo: Between Anxiety and Pleasure Danielle Quinodoz Early Freud and Late Freud Ilse Grubrich-Simitis A History of Child Psychoanalysis Claudine and Pierre Geissmann Belief and Imagination: Explorations in Psychoanalysis Ronald Britton

A Mind of One’s Own:A Kleinian View of Self and Object Robert A. Caper Psychoanalytic Understanding of Violence and Suicide Edited by Rosine Jozef Perelberg On Bearing Unbearable States of Mind Ruth Riesenberg-Malcolm Psychoanalysis on the Move:The Work of Joseph Sandler Edited by Peter Fonagy, Arnold M. Cooper and Robert S.Wallerstein The Dead Mother:The Work of André Green Edited by Gregorio Kohon The Fabric of Affect in the Psychoanalytic Discourse André Green The Bi-Personal Field: Experiences of Child Analysis Antonino Ferro The Dove that Returns, the Dove that Vanishes: Paradox and Creativity in Psychoanalysis Michael Parsons Ordinary People and Extra-Ordinary Protections:A Post-Kleinian Approach to the Treatment of Primitive Mental States Judith Mitrani The Violence of Interpretation: From Pictogram to Statement Piera Aulagnier The Importance of Fathers:A Psychoanalytic Re-Evaluation Judith Trowell and Alicia Etchegoyen Dreams That Turn Over a Page: Paradoxical Dreams in Psychoanalysis Jean-Michel Quinodoz The Couch and the Silver Screen: Psychoanalytic Reflections on European Cinema Edited and introduced by Andrea Sabbadini In Pursuit of Psychic Change:The Betty Joseph Workshop Edited by Edith Hargreaves and Arturo Varchevker The Quiet Revolution in American Psychoanalysis: Selected Papers of Arnold M. Cooper Arnold M. Cooper. Edited and introduced by Elizabeth L.Auchincloss Seeds of Illness, Seeds of Recovery:The Genesis of Suffering and the Role of Psychoanalysis Antonino Ferro The Work of Psychic Figurability: Mental States Without Representation César Botella and Sára Botella Key Ideas for a Contemporary Psychoanalysis: Misrecognition and Recognition of the Unconscious André Green The Telescoping of Generations: Listening to the Narcissistic Links Between Generations Haydée Faimberg Glacial Times:A Journey Through the World of Madness Salomon Resnik This Art of Psychoanalysis: Dreaming Undreamt Dreams and Interrupted Cries Thomas H. Ogden Psychoanalysis as Therapy and Storytelling Antonino Ferro Psychoanalysis in the 21st Century: Competitors or Collaborators? Edited by David M. Black Recovery of the Lost Good Object Eric Brenman The Many Voices of Psychoanalysis Roger Kennedy

Feeling the Words: Neuropsychoanalytic Understanding of Memory and the Unconscious Mauro Mancia Projected Shadows: Psychoanalytic Reflections on the Representations of Loss in European Cinema Edited by Andrea Sabbadini Yesterday,Today and Tomorrow Hanna Segal Encounters with Melanie Klein: Selected Papers of Elizabeth Spillius Elizabeth Spillius

TITLES IN THE NEW LIBRARY OF PSYCHOANALYSIS TEACHING SERIES Reading Freud:A Chronological Exploration of Freud’s Writings Jean-Michel Quinodoz

THE NEW LIBRARY OF PSYCHOANALYSIS

General Editor: Dana Birksted-Breen

Yesterday,Today and Tomorrow Hanna Segal Edited by Nicola Abel-Hirsch Foreword by Roy Schafer

First published 2007 by Routledge 27 Church Road, Hove, East Sussex BN3 2FA Simultaneously published in the USA and Canada by Routledge 270 Madison Avenue, New York NY 10016 Routledge is an imprint of the Taylor & Francis Group, an Informa business © 2007 Hanna Segal This edition published in the Taylor & Francis e-Library, 2007. “To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.”

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data Segal, Hanna. Yesterday, today, and tomorrow / Hanna Segal; edited by Nicola Abel-Hirsch; foreword by Roy Schafer. p. cm. — (The new library of psychoanalysis) Includes bibliographical references and index. ISBN-13: 978–0–415–41573–6 (hardback) ISBN-10: 0–415–41573–X (hardback) ISBN-13: 978–0–415–41574–3 (pbk.) ISBN-10: 0–415–41574–8 (pbk.) 1. Psychoanalysis. I. Abel-Hirsch, Nicola. II. Title. BF173.S4428 2007 2007002093 150.19′5—dc22

ISBN 0–203–41573–X Master e-book ISBN

ISBN: 978–0–415–41573–6 (hbk) ISBN: 978–0–415–41574–3 (pbk)

For my grandchildren Joel, Paul, Edward,Amber and to the memory of Alec (1979–91) and for my great-grandson Milo.

Men in their generations are like the leaves of the trees.The wind blows and one year’s leaves are scattered on the ground; but the trees burst into bud and put on fresh ones when the spring comes around. Homer, Iliad, I: 34

Contents

Foreword

xv

ROY SCHAFER

Acknowledgements

xix

General introduction

1

NICOLA ABEL-HIRSCH

Part One Papers from 2000–2006

9

Introduction

11

1

Interpretation of dreams – 100 years on

14

2

Disillusionment: the story of Adam and Eve and that of Lucifer

25

3

September 11

37

4

Yesterday, today and tomorrow

46

5

Vision

61

6

Reflections on truth, tradition, and the psychoanalytic tradition of truth

69

xi

Contents

Part Two Contributions to symposia, conferences and other occasional writings

79

Models of the mind and mental processes

81

7 Psychic structure and psychic change – changing models of the mind (1997)

83

8 The mind as conflict and compromise formation: comments on Charles Brenner’s paper (1992) 92 9 Acting on phantasy and acting on desire (1992)

96

10 Symbolic equation and symbols (1996)

111

11 What is an object? The role of perception (1990)

114

12 Projective identification: comments on Ruth Riesenberg Malcolm’s paper (1995)

124

13 The end of psychoanalysis? (1996)

130

Psychoanalytic technique

137

14 Model of mental functioning and psychoanalytic process (1992)

139

15 What is therapeutic and counter therapeutic in psychoanalysis? (1987)

151

16 The ‘corrective emotional experience’: comments on the technique of Franz Alexander (1990)

159

17 The role of child analysis in the general psychoanalytic training (1972)

165

Segal on Klein

173

18 The Melanie Klein plaque in Pitlochry (1987)

175

19 Klein (1996)

178

20 Review of Kristeva’s Le Génie Feminin Tome II – Melanie Klein (2000)

189

xii

Contents

Segal on Bion

199

21 The significance of psychic pain in the mental equilibrium (1976) 201 22 Bion’s clinical contributions 1950–1965 (1980)

203

23 Introduction to Bion (1998)

211

24 Bion’s alpha function and alpha elements (1996)

219

Envy and narcissism

225

25 Envy and jealousy (1969)

227

26 Narcissism: comments on Ronald Britton’s paper (2000)

230

Interviews

235

27 Hanna Segal interviewed by Jacqueline Rose (1990)

237

28 Hanna Segal interviewed by Dorrit Harazim (1998)

258

Bibliography Name index Subject index

265 273 277

xiii

Foreword

These searching, illuminating and challenging essays show Hanna Segal, as always, continuing to deepen our understanding and appreciation of psychoanalysis. She consistently introduces fresh insights into the guiding principles and clinical practice of psychoanalysis. Going further, she reaches well into the realms of great literature and world affairs.A true citizen of the world, Dr Segal ranges from models of the mind and the psyche’s travails during development through the complex intimacies of the psychoanalytic process to the psychodynamics of the geopolitical dangers of nuclear threat and the warrior mentality of the US presidency and religious fundamentalism. No matter the topic, Dr Segal remains dedicated to the attainment of the distinctively psychoanalytic truths. In line with traditional paradigms, she stakes her theses on the truth of unconscious fantasy. At the same time, a proper understanding of tradition requires us to engage, as she has done throughout her illustrious career, in an unending quest for new and better understanding. For example, her essays manifest increasing recognition of the role of ego structure and function, conceived in Kleinian terms, in the transformations of unconscious fantasy and their forms of expression.With her sharp eye fixed on the struggles to gain access to all areas of reality, she provides numerous case examples, many featuring brilliant analyses of both transference and dreams. A red thread running through this work is Dr Segal’s reassessment of the reality principle in relation to the pleasure principle. Meeting the surprisingly neglected challenge of reconceiving Freud’s ‘Two principles of mental functioning’ in the light of the subsequently introduced dual instinct theory, Dr Segal deals extensively and in xv

Foreword

different forms with the basic question of knowing. What is it to know? Here, as elsewhere, she repeatedly acknowledges what she has learned from Bion. (In a compact set of essays, she lucidly explains Bion’s major contributions to the analytic theory of thinking, projective identification and containment in object relations.) To know, she emphasizes, is not merely to acquire information; primarily it is to acquire through intense emotional experience an understanding of internal and external reality and the ongoing interpenetrations of the two. In this view, striving to know is life-affirming. It marks the decisive turn toward love and being loved, and of course feeding and being fed, and so being alive and whole in a world of live, whole objects. Knowing is a manifestation of no longer being dominated by the pleasure principle, seen now as the destructive servant of the death instinct; it shows instead readiness to rely primarily on the constructive reality principle. Knowing, which is achieved through the curiosity that is the sublimated version of infantile sexual voyeurism, is also linked to the ascendancy of the depressive position over the paranoid-schizoid.To know is the expression of the relative predominance of Bion’s alpha functions over chaos-inducing beta elements and of symbolic thought over the confusing concreteness of symbolic equations.The account of the last of these advances is one of Dr Segal’s particularly prized creative contributions to theory and practice. And so, to achieve some capacity to know in this enriched sense, one must be ready to tolerate the psychic pains and the disillusionment of discovering parental sexuality, separation, loss, ambivalence, limited gratification and knowledge of death. Knowing takes upkeep; we know all too well that we remain subject to internal pressures to revert to primitive modes of functioning, specifically to ruthless destructive fantasies of omnipotence and, which allows us through them, to eliminate conflict, dependency, anxiety and guilt. In the end, however, it is to enforce a lifeless, loveless existence. Going through the rigors of personal psychoanalysis certainly ranks high as a preferred route to knowing reality and gaining thereby access to life and love. And here special mention should be made of Dr Segal’s repeated reminders that the analyst’s chief ally in every analysis is the patient’s wish, so often deeply buried and seemingly inaccessible, to be whole and living among live objects.This wish to know reality helps the patient endure and perhaps use the process, but it also helps the analyst keep in check the negative transference, xvi

Foreword

the despair and destructiveness evoked and fuelled by the patient’s projective identifications. Indeed, over the course of these essays, there emerges as a major manifestation of abiding by the reality principle, namely, the analyst’s genuinely knowing countertransference and appreciating the technical importance of knowing her or his own frame of mind and its reflection in the analytic setting. Within this position and in a way that is much needed today, Dr Segal reaffirms the cardinal role of interpretation in facilitating psychic change, and she throws new light on the nature and assessment of the changes brought about through analysis. Her shrewd and candid discussions of technical issues should benefit every reader. In this context and adding to these essays’ persuasiveness we find two of Dr Segal’s recent studies: that on John Milton’s Paradise Lost in which she views this masterwork through the lens of what it is to know the realities of life, and that on September 11 in which she speaks out on behalf of the responsibility to speak out, as she has done, once we truly acknowledge the dangers to our existence created by the irrational militancies of the Cold War and now of the Middle East crises. Beyond understanding, knowing entails activity. Other significant trends in cultural and social life are not neglected. Remaining always within the tradition of psychoanalytic understanding established by Sigmund Freud, Melanie Klein and Bion, Dr Segal also takes in – or takes on? – feminism, French psychoanalysis and other timely topics, in each instance successfully clarifying the merits and problems of positions taken in these controversial areas. A number of the contributions contained herein date from past years. Some have been published, some are panel presentations and discussions of papers or books by others, and two are extended interviews. All add to the breadth and depth of Dr Segal’s principal theses. How much Dr Segal has to offer! Mindful of her linking truth, reality, life and love, I would call this book not only a proof of the fruits of curiosity – food for thought aplenty – but a gift of love for which we readers can only be profoundly grateful.

xvii

Acknowledgements

An analyst does not work in isolation and I am grateful to many colleagues and students, dialogues with whom always enrich my mind. They are too numerous to mention, but I want specifically to thank Betty Joseph and John Steiner who saw parts of the manuscript at various stages and always made the most helpful suggestions. My particular thanks go to the editor, Nicola Abel-Hirsch, who made sense of the project through her research, editing and introductions; her assistant, Annie Pesskin, who so ably sub-edited the papers and compiled the bibliography and index, and Mary Block, my secretary, without whose help I could hardly function. The following kindly gave permission to use previously published material: (2003) The Iliad, Homer.Translated by E.V. Rieu. Penguin UK. (2001) Interpretation des rêves cent ans après, Journal de la Psychanalyse de l’Enfant, 28.Translated by Francis Drossart. (1992) Acting on phantasy and acting on desire, Psychoanalysis, Mind and Art: Perspectives on Richard Wollheim, ed. J. Hopkins and A. Savile. Oxford: Basil Blackwell. (1972) The role of child analysis in the general psychoanalytic training, International Journal of Psychoanalysis, 53: 157–61. (1992) Model of mental functioning and psychoanalytic process, Journal of the American Psychoanalytic Association, 40: 801–26. (1990) What is an object? The role of perception, Psychoanalysis in Europe, Bulletin 35,Autumn. (1996) Klein, Dictionnaire Internationale de la Psychanalyse. (1996) Symbolic equation and symbols, Dictionnaire Internationale de la Psychanalyse. xix

Acknowledgements

(1996) Bion’s alpha function and alpha elements, Dictionnaire Internationale de la Psychanalyse. (1990) The ‘corrective emotional experience’: comments on the technique of Franz Alexander, Psychoanalytic Inquiry, 10: 409–14. (2000) Review of ‘Le Genie Feminin Tome 11 – Melanie Klein’ by Julia Kristeva, International Journal of Psycho-Analysis, 28(2): 401–5. (1990) Hanna Segal interviewed by Jacqueline Rose, Women:A Cultural Review, 1(2): 198–214. (1998) Hanna Segal interviewed by Dorrit Harazim, Veja, 31(16): 22 April.

xx

General introduction

Hanna Segal is best known internationally for her work on symbolisation. This work is part of a lifelong endeavour to explore the intricate relationship between creative and psychotic functioning. Here, in her sixth book and third collection of writings, she pursues this study through current thoughts on the nature of dreaming, to new ideas about vision and disillusionment, models of the mind and the two principles of mental functioning. Her long interest in factors affecting war is pursued in her examination of the psychotic factors, symbolic significance and psychological impact of the events of September 11 and the following war on Iraq. An outstanding clinician and theoretician, it would be hard to overestimate Segal’s importance in the British Society and in the Klein group in particular. Over a career spanning more than 50 years Segal has made many significant contributions of her own and has been the main exponent of the work of Klein and one of the clearest exponents of Bion’s earlier work. She is one of the few analysts whose ideas are well known outside analytic circles. In his introduction to Segal’s most recent publication Psychoanalysis, Literature and War (1997), John Steiner draws attention to two related themes: the clinical usefulness of the death instinct and the relationship between phantasy and reality. It is striking how frequently Segal writes papers about contrasting pairs of concepts.We see this in her earliest papers on symbols and symbolic equations, creativity and delusion, and schizophrenia and depression; in her later papers on the life and death instinct and phantasy and reality; and in this book she twins the fall of Adam and Eve with the fall of Lucifer 1

Yesterday, today and tomorrow

(‘Disillusionment’, 2000), and in ‘Vision’ (2004), voyeurism and curiosity are considered. In all these papers Segal is exploring the border region between the contrasting pair, for example, when patients are emerging into depressive position functioning, or conversely when patients are vulnerable to psychotic breakdown. The border region is, in my view, where the most growth (or deterioration) occurs. It is not a comfortable place for either patient or analyst, but a place that Segal explores clinically and intellectually more deeply than most. Hanna Segal was born on 20 August 1918 in Lodz, Poland, where her father had been temporarily assigned to work for the nascent government of the Polish Republic.When she was 3 months old the family returned to Warsaw where her father had a legal practice. Her parents were of Jewish origin, but primarily identified with Polishness and the Polish Independence Movement. From as far back as she can remember Segal’s father had a great influence on her intellectual development and interests. He read her ‘the best of childhood literature’, sometimes translating it from French or English. He knew very little about science and was pretty hopeless about practical matters, but aroused her interest in the humanities and was an inspiring influence all round. Her mother, who came from a much less intellectual background, Segal admired for her quick intelligence and great stamina in times of trouble when she kept the family together. Her mother was quick to adapt to the family’s changing circumstances from riches to near poverty and from one country to another. As was usual in her culture, when she was a young child Hanna was largely in the care of maids as her parents travelled. Her early childhood was overshadowed by the death of her sister,Wanda, who died aged four when Segal was two and a half years old. As Segal’s parents had often not been at home, Wanda had been a major ‘good object’ for Hanna. When she was 13, her father moved the family to Geneva. For Hanna this was a powerful time of change. Partly because being a lonely child living in a flat in Warsaw, she had become very attached to her school, and being torn away was a traumatic event. However, it was a time when her mind was opened to the world because she went to a remarkable school in Geneva.The Ecole Internationale was 2

Introduction

extraordinarily liberal and progressive for its time and its pupils were children of many different nationalities, continents and backgrounds. Segal’s first encounter with this new reality was having an inkpot thrown at her. She met a Lithuanian girl, called Victoria, to whom she ran with open arms saying, ‘We are compatriots’ but the girl threw the ink pot at her. It was, she said, like an Englishman meeting an Irishman and telling him they were compatriots. In her Polish school, she had been taught that the union between Poland and Lithuania led to a glorious Polish/Lithuanian empire.While this might have been true for the Lithuanian aristocracy, for the vast majority this was simply conquest and oppression by Poles. So in Geneva she learnt tolerance and a wish to understand all the cultures present, and she aspired to have freedom from religious and nationalistic attitudes. Segal returned to Poland aged 16 because she wanted to take the Polish ‘Matura’. It was in her adolescence that she discovered Freud’s writings and was immediately gripped by them. She decided that what she most wanted to do was psychoanalysis. For Segal, the ruling passions in her life since adolescence have been ‘art and beauty’ and something she used to call socialism and now calls social justice. Once she had discovered psychoanalysis she found that it satisfied and integrated these passions. From the age of 16 Segal actively sought how to train as a psychoanalyst. She was misinformed by the only Polish analyst, Bychowski, that you had to have a medical degree and you had to go to Vienna. She had no objection to doing medicine, though it was very hard for a woman and a person of Jewish origin to get a place, but she had no intention of going to Vienna. At the outbreak of the Second World War, when Segal was in her third year of medicine at Warsaw University, she was in Paris with her parents.The family escaped on a Polish boat to Britain. By then both Freud and Klein were in England. In Edinburgh she was able to resume her medical studies and it was there that she met the psychoanalyst Ronald Fairbairn, who at last told her about the Institute of Psychoanalysis in London. He gave her two books to read, Anna Freud’s The Ego and the Mechanisms of Defence and Melanie Klein’s The Psychoanalysis of Children. She was immediately enchanted by Klein’s book with its richness and its depth. It brought to her mind an incident from the past. When she had been on one of the evacuation trains from Paris during the war, an adolescent girl had had a sudden 3

Yesterday, today and tomorrow

schizophrenic breakdown.As a medical student Segal was the nearest thing to a doctor on the train.The girl’s overwhelmed parents asked her to look after their daughter. Segal listened carefully to the content of the girl’s ‘babble’. She kept screaming ‘I shat my lover in the loo’. When Segal read Klein she suddenly realised that the girl’s words had obvious meaning and could be understood.The girl was being evacuated but in her mind she had reversed the situation, she was doing the evacuating. It was the language of unconscious phantasy which Segal discovered in Klein’s book. After qualifying in medicine Segal came to London and after some insistence on her part she began an analysis with Klein which was to last about nine years. On an informal note, while in analysis with Klein, Segal began to write a detective novel. It was never finished. Segal’s ‘psychoanalytic super ego’ required her to concentrate on analytic subjects. When she finished her analysis Klein commented that she was sorry Hanna had not finished the novel, as she had looked forward to reading it. Segal noted that it is all too easy to see one’s analyst as a critical figure. Segal’s supervisors during her psychoanalytic training were Joan Riviere and Paula Heimann, both of whom she respected greatly. She completed her analytic training in 1945 at the age of 27. She was appointed as a training analyst only five years later and also went on to train as a child analyst. The two years following qualification are seen by Segal as crucial in her development. In those two years she was pregnant with her first child and wrote her first two papers. The first, though published later, was ‘A psychoanalytic approach to aesthetics’ and the second her membership paper on ‘Some aspects of the analysis of a schizophrenic’. She says that this work laid the foundations of a semiconscious plan for the rest of her life. This was the foundation for her two great interests: creativity and psychosis. Published originally in the International Journal of Psychoanalysis, these papers, and others written over a period of about 30 years, were finally brought together and published in Segal’s first collection, The Work of Hanna Segal: Delusion and Artistic Creativity and other Psycho-analytic Essays (1986). Her early years as a psychoanalyst also saw the publication of her first two books. Introduction to the Work of Melanie Klein (1964) illustrated by clinical material from Segal’s own patients and Klein (1979) in the Fontana Modern Masters series, written for a popular audience 4

Introduction

and illustrated by Klein’s clinical material.These two books formed Segal’s tribute to Klein. At this time Segal did not write anything on sociopolitical issues, her other passion. She told me she started writing on these issues almost accidentally. She did her duty as a citizen and it did not occur to her to write about these subjects until 1983, when, under the impact of the cruise missile crisis, she and Moses Laufer initiated a group – Psychoanalysts for the Prevention of Nuclear War (PPNW) – under the aegis of the British Psychoanalytic Society. This group developed and sought to extend their work to the international arena. The first possible opportunity for this was the 1985 congress in Hamburg. This congress was particularly relevant as it was the first international congress to be held in Germany since the Second World War. Robert Wallerstein, the new President elect of the International Psychoanalytical Association organised a meeting to inaugurate the International Psychoanalysts Against Nuclear Weapons (IPANW) and invited Segal to give the opening address.This resulted in her paper ‘Silence is the real crime’.The group worked with other anti-nuclear groups and was responsible for a body of work examining the nuclear threat and unconscious and psychic factors involved in the causes of wars. Segal’s first papers had been conceived on the ‘long and leisurely’ car journeys from Chislehurst and Epsom in south-west London to Clifton Hill, St John’s Wood for analysis with Klein. She would then work the paper out, write some notes and dictate the final draft to a secretary. She commented that as the traffic increased and she got older and richer she would also dictate earlier drafts. Segal likes dictating to a person – ‘a direct communication’. Her fourth book, Dream, Phantasy and Art (1991) was written when she was the visiting Freud Memorial Professor of Psychoanalysis at University College London. A story got out that Segal just sat back in her chair, lit a pipe and dictated the book to her secretary as if with no prior preparation. On hearing the story a patient of hers, who was a writer, had enviously protested at the apparent ease of the endeavour.The final step of dictating was however the outcome of a deep and vigorous engagement in psychoanalysis in which Segal worked things through in her mind and in detailed notes first. She says she does not write much on holiday. Paul, her husband, bought a big old desk as one of the first pieces of furniture when they started restoring a house in the 5

Yesterday, today and tomorrow

Dordogne 40 years ago. It was placed in front of a window, but was not very much used. Segal has devoted her professional life to practising, teaching and writing about psychoanalysis. She has held many important posts in British and international psychoanalytic organisations including President of the British Psychoanalytical Society and Vice-President of the International on two occasions. Segal retired from clinical practice in 2000 when she could no longer maintain the clinical setting because of her physical health. Although not able to travel much abroad she continues to conduct seminars in her study or by telephone link. She now avoids public ‘performances’ but in 2006, on the 150th anniversary of the birth of Freud, she gave a paper at the Tavistock Clinic in London and agreed to appear on the BBC radio programme Desert Island Discs. Segal’s understanding of the importance of achieving real freedom of thought inspires not only her work and writings, but is also reflected in her relation to colleagues and students. Segal does not have a personal group following. She has many people who have been deeply influenced by her analysis, supervision and writing, but this is not the same thing as having followers. At the same time Segal has deep convictions and is prepared to fight for ideas.This includes her stand on the principles of psychoanalytic technique and, in the public sphere, her work on nuclear and war issues. Segal’s influence was confirmed from an unexpected quarter when it was discovered that, unbeknown to her, a quotation from an early paper ‘A psychoanalytical approach to aesthetics’ was used as a rallying call for the World Trade Center Mural Project.The project was set up following the terrorist attack of September 11 with the aim of creating a mural, 70 feet high, on the Equitable Building in NewYork as a symbol that life could survive destruction. The quotation used was the following: ‘It is when the world within us is destroyed, when it is dead and loveless, when our loved ones are in fragments, and we ourselves in helpless despair – it is then that we must recreate our world anew, reassemble the pieces, infuse life into dead fragments, recreate life’.2

2 Segal, H. (1952). Also in The Work of Hanna Segal: 185–206.

6

Introduction

The content and layout of the book Hanna Segal’s initial half-humorous suggestions for this book’s title were ‘Bits and pieces’ and ‘Odds and ends’. This was seriously to downplay the contents of the brown folder she gave me at our first meeting about the book. The folder contained five new papers: ‘Interpretation of dreams – 100 years on’,‘Disillusionment: the story of Adam and Eve and that of Lucifer’,‘September 11’,‘Yesterday, today and tomorrow’ and ‘Vision’. It also contained occasional writings dating back to the 1980s, including her contributions to conferences on Bion, projective identification and narcissism. To this we added other occasional writings, comments of hers made from the 1960s onwards and recorded in the British Psychoanalytical Society Bulletin3 and a number of papers published elsewhere. Finally, while the book was being prepared, Segal wrote a sixth paper,‘Reflections on truth, tradition and the psychoanalytic tradition of truth’ which we have also included. In all there are 28 pieces ranging from brief comments to full-length papers. The writings have been arranged in two parts: Part One contains the main papers and Part Two Segal’s contributions to symposia, conferences and other occasional writings. Part Two has been further divided by theme into models of the mind and mental processes, psychoanalytic technique, Segal on Klein, Segal on Bion, envy and narcissism and the interviews.

3 For reasons of confidentiality the Bulletin is only available to members of the British Psychoanalytical Society.

7

PA R T O N E

Paper s from 2000–2006

Introduction

The first paper in this book,‘Interpretation of dreams – 100 years on’ (2000) considers the nature of dreaming in psychotic and nonpsychotic functioning. Segal notes the change in her own and her colleagues’ thinking. Now we pay closer attention to the level of symbolisation in the dream (symbol or symbolic equation), noting how the dream functions (representation or evacuation) and what function the dream fulfils in the transference. As Segal puts it, we are to analyse the dreamer not the dream. In this paper Segal suggests that Freud’s later work on the life and death instincts has new implications for understanding dreams and she contends that the basic wish fulfilled by the dream is the wish of the ego to resolve conflict. ‘Disillusionment: the story of Adam and Eve and that of Lucifer’ (2000) was completed around the same time. It is not only clinical but also links with Segal’s interest in literature. She shows how a great poet like Milton, with his poetic intuition, can describe the basic psychological processes at work in Lucifer. Segal uses some of the same material from the ‘Interpretation of dreams – 100 years on’ paper to show how similar to Lucifer’s scenario are the tremendous struggles of psychotic patients to regain their sanity. The psychotic disillusionment of Lucifer is contrasted with the non-psychotic disillusionment of Adam and Eve when they are expelled from paradise into ordinary reality and life.The relationship between the psychotic and the non-psychotic world is vividly explored in Lucifer’s return to the border of Heaven. At the beginning of his residence in Hell Lucifer is not completely cut off from 11

Yesterday, today and tomorrow

non-psychotic reality. He has a memory of what he has lost and he wants to get out of Hell. He journeys across Chaos to God’s domain. When he arrives he sees both Heaven and the new world of man that has been created. Faced with loss of pride, envy of God and Jesus, pain at Adam and Eve’s sexual bliss and guilt about the damage he has done Lucifer returns to Hell and declares war. In her analysis of psychotic group processes in the third paper, ‘September 11’ (2001) Segal describes a somewhat analogous situation occurring at the time of perestroika. This was a time of hope – a potential shift in attitudes – if all sides could turn their attention to domestic internal problems and give up their paranoid view of the other. Instead, triumphalism ruled the day in the West, and new enemies were found. As with Lucifer in Milton’s Paradise Lost there was a return to Hell and a declaration of war. Some colleagues feel that Segal wrongly attempts to understand society by extrapolating from the individual-in-psychoanalysis to society-at-large. Segal argues, however, using Bion’s theories of group psychotic processes, that psychotic forces can powerfully distort the sane and constructive functioning of a group. The ‘September 11’ paper develops the analysis contained in Segal’s paper ‘Silence is the real crime’ (1987) and in her 1996 paper ‘From Hiroshima to the Gulf War and after: socio-political expressions of ambivalence’ (1996). She shows the psychotic factors in the background of September 11 and analyses the symbolic significance and psychological impact of September 11 and the ensuing war on Iraq. The fourth paper, ‘Yesterday, today and tomorrow’ (2001) gives a clear view of the development of Kleinian thought in Britain and in particular of the development of Segal’s own thought. It is not in her eyes a weighty paper, but sets out clearly and succinctly what she deems to be the essential elements in psychoanalysis. It was in the presentation of this paper that Segal’s somewhat new link between the pleasure principle and the death instinct was brought to the attention of an audience and it was this idea in the paper that was particularly commented on in the discussion at the meeting and since. In the fifth paper,‘Vision’ (2004) Segal returns to clinical concerns. Her view that voyeurism is a central factor in the psychotic process is a new area for enquiry. While preparing the ‘Vision’ paper for this book, Segal commented that she wished she had known what she knows now about voyeurism in some previous treatments of patients. 12

Papers from 2000–2006

The paper addresses the border between healthy curiosity and the voyeurism which distorts and perverts it.With psychotic patients she has observed that a breakdown is often preceded by an increase in voyeuristic activities and that being aware of this can enable it to be contained in the analysis. Segal suggests that the particular importance of vision may be related to the fact that, out of all the senses, vision directly presents the infant with the fact of mother’s separateness. It is this which is attacked, using the eyes as a channel for projective identification, to destroy the reality of the external world and the reality of their own impulses.This creates the hallucinatory world of madness, as when Lucifer saw Heaven across the border and turned away in rage to an omnipotent, omniscient and psychotic Hell. In her sixth and most recent paper,‘Reflections on truth, tradition and the psychoanalytic tradition of truth’ (2006), Segal addresses the basic problem of the status of analysis as a scientific procedure. The paper is purely theoretical – the only long paper of Segal’s which contains no clinical material. This is the culmination of a trend in her later work which addresses psychoanalytic, moral and political issues in a directly theoretical mode. It corresponds with a transfer of emphasis in her life from treating patients to supervising and writing. In this paper Segal discusses the parameters established by Freud and shows how postulates from Freud’s theories and methods or procedures fit in with the criteria of the modern philosophy of mind and science. She seeks to validate the psychoanalytic claim that it is a new science and also considers what procedures could be seen as adverse to the development of this new science.

13

1 Inter pretation of dreams – 100 year s on

This paper was to be given at the Freud Museum in Vienna on the 100th anniversary of the publication of Freud’s Interpretation of Dreams (1900). Unfortunately Segal was unable to attend because of illness and the paper was presented by a colleague.4 This is the first publication in English.5

Psychoanalysts love dreams and most of our patients know it. Many years ago, a patient was very co-operative in his analysis. He brought a number of dreams with fruitful associations. As time went on I became a bit suspicious. It seemed too good to be true. One day he started a session saying, ‘I’ve got a fruity one for you today’. He dreamt that he was alone on a sledge somewhere in Siberia being pursued by wolves. He was alone and frightened but he had a supply of fresh meat and kept throwing chunks of it to the pursuing pack thus keeping them at bay.The meaning of the dream wasn’t hard to find – analysts can be warded off by juicy dreams. The rest of his analysis wasn’t all that easy. Freud is often quoted as having described dreams as ‘the royal road to the unconscious’. This is a misquote – Freud actually said, ‘The interpretation of dreams is the royal road to a knowledge of the unconscious activities of the mind’.6 In The Interpretation of Dreams7 4 5 6 7

Dr Gigliola Fornari Spoto presented the paper with her own material. Segal, H. (2001b) The paper has previously been published in French. Freud, S. 1900. Chapter 7, section on The primary and secondary processes (part E). Freud, S. 1900.

14

Papers from 2000–2006

he gives us the key to the understanding of a whole new world – the world of our dreams, our unconscious phantasies, which are the basic matrix of our personality. He introduced us to the world of dream thought and dream language.These are irreversible discoveries basic to our view of the world in the same way that whatever new discoveries we made about astronomy since Copernicus nobody can ever again think of the earth as being flat. It is a basic tenet of psychoanalysis that dreams have a psychic meaning and a psychic function. They arise out of psychic conflict and express themselves in the dream language, the language of mental representation.These are the unchangeable laws of dream functioning.To the end of his life Freud considered The Interpretation of Dreams his most important book.This is not surprising as the understanding of dream language was the key to the understanding of unconscious phantasy because it is in dreams, unimpeded by rational thought or current events, that unconscious phantasy expresses itself most richly and directly.According to Freud, the aim of the dream is the fulfilment of repressed unconscious wishes through mental representation. But Freud’s later work brought new problems. For instance, what wish is fulfilled? After 19208 it wasn’t possible any more to think of a simple libidinal wish fulfilment. Did the dream fulfil libidinal wishes or the wishes of the superego (and the superego, according to Freud, is infused with the death instinct)? I think that the basic wish which is fulfilled by the dream is the wish of the ego to resolve conflict. I would say that the dream work is a working through. Freud didn’t basically revise his theory of dreams in the light of his later concepts. I think he refers to the workings through in relation to dreams only once in his later work. Nevertheless, his later work inevitably threw a new light on our understanding of dreams. For instance, a reformulation of his instincts theory:9 his new theory argued that the basic conflict is between life and death instincts. The increasing importance he gave to internal object relationships, his discovery of the transference, etc. all led to a new perspective on mental phenomena including, of course, dreaming.

8 Freud, S. 1920. 9 Freud, S. 1920.

15

Yesterday, today and tomorrow

Looking at his concept of dream work one is impressed by how great is the psychic work performed by the ego in creating a dream. Freud addressed himself to the question,‘What happens if the dream fails to fulfil its function?’ One could re-word it,‘What happens if the ego is unable to perform the psychic work involved in the dream?’ A central part of dream work is to evolve a symbolic language.The failure of dream work reflects a failure in symbol formation. Klein initiated the study of symbol formation and described some of its psychopathology. She recognised the all important role of symbol formation for the development of the ego.10 She views symbol formations as the basis of sublimation. In the paper,‘The importance of symbol formation in the development of the ego’, based on the analysis of an autistic boy, she addresses herself to the pathology of symbol formation and demonstrates how the inhibition in symbol formation leads to an arrest in the development of the personality. In that paper she deals with the inhibition of symbol formation. In 1954,11 I suggested that there can also be a malformation rather than inhibition of the process. I suggested that there is a difference between what I call symbolic equation deriving from the paranoid-schizoid position and proper symbols which can only be formed in the depressive position. In the paranoid-schizoid position, excessive projective identification results in concrete equations – a part of the ego is confused with the object and, as a result, the symbol that is a creation of the ego becomes equated with the object resulting in a concrete equation. In the depressive position the total possession and identification with the object is gradually given up and the mourning process related to the loss of the object results in the setting up in the internal world of an internal object which is not wholly identified with or confused with the actual external object.Thus the symbolic function is initiated. In Bion’s words the infant recognises that ‘no breast; therefore a thought’.12 Bion further extended this work by analysing the elements of which concrete symbolisation is formed. I am sure you are all familiar with Bion’s concept of ‘container’ and ‘contained’.13 According to him, the infant projects into the mother 10 11 12 13

Klein, M. 1930. Segal, H. 1954. Bion, W.R. 1962a. Bion, W.R. 1959.

16

Papers from 2000–2006

inchoate elements which he calls beta and if those elements are taken in and appropriately responded to by the mother they get transformed into alpha elements which become elements of symbolism and are capable of further transformations. I see it as beta elements acquiring psychic meaning. Beta elements only lend themselves to projection but alpha elements are ‘such stuff as dreams are made of ’. They are elements of dream thought and phantasy. We know that dreams are related to repression. Jones14 said that only what is repressed is symbolised: only what is repressed needs symbolising and, I would add, needs to be dreamt. But according to Jones and Freud15 the repression must not be too severe. It must be porous and flexible. According to Klein,16 repression sets in only in the depressive position when there is a differentiation between inner and outer reality. Splitting, introjection and projection are more primitive mechanisms. I suggested that excessive repression is in fact a splitting off of unworked-through psychotic anxieties and defences. Bion17 distinguishes between the contact barrier in which primitive beta elements are constantly being transformed into alpha elements (in which symbolisation develops) and the beta screen which becomes an impenetrable barrier between the conscious and the unconscious. Beta elements are unlike alpha elements in that they cannot be integrated – they can only be amalgamated and that amalgamation becomes a beta screen. In so far as dreams are concerned, it is not that there are no dreams in the psychotic part of the personality but that they fulfil another function – not that of working through psychic conflicts but of expelling them.This is a functioning of the psychotic part of the personality and is linked with concretisation. Alpha elements can evolve further but beta elements can only be expelled and the dream is experienced not as one’s own psychic product but as a bad object to be expelled. Bion18 refers to patients who are ashamed of their dreams and equate having dreamt with being incontinent in their beds. 14 15 16 17 18

Jones, E. 1916. See II. True Symbolism in this essay. Freud, S. 1900, Chapter 7, part E (The primary and secondary processes). Klein, M. 1958. Bion, W.R. 1962a. Bion, W.R. 1959.

17

Yesterday, today and tomorrow

Freud spoke of the dream as a night-time innocuous hallucination.19 I do not quite agree with that formulation. The dream is not an hallucination when it fulfils the dream work. It is a representation, a symbolisation. But a dream is almost indistinguishable from an hallucination when it is felt as a concrete object and is expelled, becoming part of the external world.

Case material For example, Edward, my first schizophrenic patient20 would flood the session with vivid descriptions of what happened to him at night, for instance, descriptions of snakes crawling out the walls. To begin with, it was impossible to know what was an hallucination and what was a nightmare he had woken up from, or what was reality, for instance, when he described nurses beating up patients – hallucination, dream or reality? Sometimes this hallucinatory aspect is more concealed, particularly in borderline patients. They know they had a dream, they refer to it as a dream and yet it functions in the psyche as an hallucination. They live as though the dream were true and it invades their reality and distorts their perceptions. For instance, a patient, Miss B., would complain bitterly that my room smelt of gas. It turned up in the session that she dreamt of bursting gas balloons. Or sometimes she would attempt to quarrel with me throughout the session, enacting her dream of the night in which she had a quarrel with a thinly-disguised representation of me. In that way she was expelling the dream by violently actualising it in the session. By the way, it is often characteristic of these dreams that they have very poor symbolisation. She repeatedly dreamt of houses which had a restaurant at the top, sexual scenes in the middle and dirty basements. This kind of house was often the setting of her dreams. Mr H., another patient I frequently quote, who indulged in promiscuous, masochistic sex, frequently dreamt of a guardsman or some similar figure with a flaming sword pursuing him. Sometimes a kind of working-through is achieved, but expelled by the way the dream is treated. Mr H. had very deep and

19 Freud, S. 1900. 20 Segal, H. 1950.

18

Papers from 2000–2006 moving dreams about his mother’s death which he wrote carefully in his notebook and which, over a period of time, he would present to me now and then in the session. But, apart from dreams, he showed no mourning for his mother and never shed a tear. This paralleled his behaviour after the sessions when he would spend hours in the lavatory defecating and writing notes of his session – an activity he called ‘post-analysis’ and considered more important than the actual analysis he was having. Interpreting the content, of course, would have lead nowhere, but I cannot say that interpreting the meaning of the action of his telling me the dream led much further and as time went on he used his dreams (often full of violence) in more and more complex ways. To understand the function fulfilled for him by the dream necessitated, as in all such situations, a minute attention to when and in what context it was presented, in what way and how it affected the session. Projection is always into an object – often an internal object in the intrapsychic process. When one is in analysis the analyst is the object. We have learned not only to pay close attention to the level of symbolisation in the dream and how it functions, but also to be responsive to what function it fulfils in the transference. To Mr H., I was a ‘shitbag’. The way he related to me his dreams showed he was defecating his mother and the part of himself capable of mourning into me. This certainly affected his perception of me, but there are always two aspects to this kind of projection. One is the wish to expel something internal, but the other is to affect the object. Part of Mr H.’s enactment had to do with the attempt to make me into a shitty, despised object. In Mr M. the need to control and change the object was more in evidence. At the beginning of his analysis, he used to flood me with dreams and numerous associations. When I pointed out to him his inability to listen to the interpretations and the way his numerous associations, with which he interspersed the telling of the dream, were in fact obscuring the meaning, rather than helping me to clarify the dream, he was very shocked and surprised. He said he thought that was how one analysed dreams – ‘Isn’t that how Freud analysed his Irma dream?’ It soon became apparent that he was being Freud, analysing his own dreams with me as his dazzled and mesmerised audience. After some analysis of the meaning of his way of dreaming and recounting his dreams, he produced a few shorter dreams with more coherent and pertinent associations. Those dreams, and the associations to them, dealt with and illuminated the psychic function of his dreaming and recounting the dreams.

19

Yesterday, today and tomorrow He dreamed that he was injecting anti-rabies serum into a big football. It was important that not a drop should touch him. He was also carelessly putting something into a woman’s purse. He associated to his promiscuity and seduction of women – an activity which he wished to see as reparative (the serum) – but which was, in fact, destructive and projective. He had a conviction that when he approached a woman, he had the power to implant in her what he called ‘the need for M.’, thus projecting his own infantile need into the woman. Once so infected, only intercourse with M. (the serum) could save them. But the injection by his penis was re-infecting them – getting them more addicted to him. The serum in the dream is destructive and not a drop must touch him. This, of course, is also a reference to analysis. He injects his dreams into me, to excite and control me, but not a drop of an interpretation must touch him. The next day the situation became even clearer. He washed his hair just before the session and literally soaked my pillow. He had a dream of piercing a balloon and making it burst. ‘It popped like a cherry.’ He associated this dream with the previous one of injecting the football. It had become clear that for him his profuse dreams and his way of telling them to me were like a stream of sexualised urine, meant to dazzle, seduce, confuse me, and make my mind burst. He was motivated both by his need to get rid of his own infantile needs and by envious rivalry with me. He was Freud in the sessions. (Note also the theme of injection continuing the identification with the Irma dream.) Sometime later he brought four dreams. I shall not give them all but one of the dreams is relevant to my theme. He dreamed that he was putting tiny fragments of something into two oval shapes which became warped. He was also trying to bring them together. He interrupted himself to associate that the shape reminded him of a grapefruit, since later in the dream he was buying a grapefruit from a woman and was annoyed that the price had been raised. (His fee had been raised shortly before this.) He thought the small fragments were his disintegrated dreams and he hoped that putting them in the oval shapes and bringing the shapes together meant he was integrating them. He used an expression typical of him – ‘I want it to mean that’ – then he continued the dream. He was running in a transparent warped passage. There was a supervisor at the entrance who might not let him into the place he was running to. Then came the grapefruit part. Possibly he had to buy a grapefruit from a woman to get in. I think that in this dream it is the warped grapefruit and the warped corridor that are the essential clues and that was the centre of my inter-

20

Papers from 2000–2006 pretation. The other three dreams contained fragments of a fragmented and projected oedipal situation – for instance, projecting his oedipal feelings into his daughter. In the fourth dream he shows how by putting his dreams into me – the oval shapes, the breasts, the grapefruit he has to buy – he is both projecting a fragmented oedipal situation into me and warping my judgement. His ‘I want it to mean’ is also his wanting me to interpret the dream’s meaning to be what he wants it to be, so that I would let him ‘into the place’. But in fact dreaming and telling me dreams were experienced by him as an actual urinary intercourse in which he both projected parts of himself into me and wished to affect my mind – burst it, as in the previous dreams – or warp it. His conviction that he could affect my mind that way led to his tendency to experience his analysis as a folie a deux, reproducing his experience with his mother, who eroticised her relationship with him and idolised him in a virtually delusional way. Dreams were, of course, only one of the manifestations of this process, but a very central one. All dreams are partly acted out and in. After all, we all want to have our dreams realised. But in psychotic functioning dreaming is part of a whole system in which acting in is the main function. We have to be very aware of whether the dream is primarily meant to communicate or to disrupt communication. Of course, that disruption is also a communication when we understand it, but it does not necessarily mean that it was meant to be a communication. All this presents us with enormous technical difficulties. In Mr H. and Mr M., despite the acting in and projective identifications, one can discern shapes of objects but sometimes we meet with a use of dreams almost as a pure bombardment by beta elements. The technical difficulties are compounded by the fact that we are never confronted with a functioning that is purely sane or purely mad. In greater or lesser measure we have to analyse both aspects of the dream and the associations in any particular session. There are always fluctuations and I observed a strong increase of regression to psychotic functioning often presaged by a change in the nature of dreams in two situations. One is an impending psychotic breakdown. The other is violent negative therapeutic reaction to improvement. Approaches to the depressive position often provoke regression to psychotic modes of defence. It often appears on the termination of the analysis. I observed it particularly appearing in a striking and violent way in a patient who had a history of severe manic breakdowns in relation to the termination of his analysis. A moment was approaching when the patient

21

Yesterday, today and tomorrow started thinking of the necessity of ending and I was of the same opinion. In the first year, when we still discussed a possible date a very great deal of work was done, particularly his growing acceptance of his disillusion that a successfully completed analysis did not mean the fulfilment of any of his obstinately grandiose phantasies. In the second year, things became much harder. He was constantly in conflict between accepting how much he had improved and how much life still had to offer him as against an ever increasing pull to regress into a psychotic breakdown. This, of course, was also used to blackmail me not to stop. He had a series of dreams with very painful insights about the oedipal situation but nearly always some apparently unimportant element of the dream would release a violent barrage of beta elements. To give a couple of examples, in one dream his wife wanted to leave him, because of his inadequacies, for a handsome blond man. He tries to be generous in the dream and tells her, ‘You have the choice’. But he has an erection which he thinks will tempt her to come back to him and overlook his other inadequacies as a proper husband. Then he realises that the other chap also has an erection and his wife does leave him. He then breaks down and sobs uncontrollably. She comes back and comforts him and tells him that if he minds that much of course she will stay with him. The dream linked with a lot of previously worked through material like his overestimation of the magic power of his erections. In the dream he realises that it is not so but still believes he can seduce her into staying by crying. (When he was 15 he often cried aloud in his bed and his mother would leave the marital bed to comfort him until his father put a stop to it.) As he had started the session by telling me he was in an angry mood I pointed out to him that maybe his anger was linked with his recognition that not only would I not be dazzled by his exhibitionism but I would also, unlike his mother at 15, not be seduced by his tears. Then about halfway through the session, he suddenly remembered there was something in the dream about Bion. He admitted guiltily that he ‘got into’ the Internet to listen to a discussion about Bion. (He is a complete addict to surfing the net and gets into enormous sexual excitement when it makes him feel that his eyes get inside my marital bed or my mind.) After that he filled the rest of the session with excited, violent, disjointed bits of information, particularly about Bion. Did I know that he analysed Beckett? Did I hear how ungrateful he was to Klein? According to the patient, Bion went off the rails when he started the pursuit of ‘O’ and did I know that in California the ‘Big O’ means an orgasm, etc. All I could say at the end

22

Papers from 2000–2006 of the session was that he wanted to destroy our understanding of his pain about ending analysis by converting the session into one giant orgasm. The following week, he again brought an insightful and very moving dream. He meets a woman called Ann Kuhlson.21 There was some project in the background which was in trouble, possibly because of some misdemeanour of hers, which meant that some feminist or other leftwing meeting could not take place. He is extremely helpful to her at the meeting and hopes that she will give him an opening for a sexual affair. But she makes it clear that though she appreciates his help and is willing to accept it, any romance between them is out of the question. Sadly, he accepts this and returns to his real life, his wife, his work, etc. and in fact is not too disappointed. In fact he prefers his wife to Ann. The associations were in keeping with the mood of the dream. He associated to his having been helpful in the previous session when he replaced the casters which had slipped off the couch. Ann is an important character in his history. In adolescence he had a desperate infatuation with her and pestered her incessantly, the beginning of what later became his de Clèrambault-like syndrome.22 But when he eventually went with her to a dance, he got drunk and vomited all over her lap. The gist of our understanding was his recognition that a person like the analyst who had dealt with his vomit, urination, defecation, crazy erotic transference etc. could remain his friend and accept his help, but could never become his mate. In the dream he is not too disappointed. He realises that he has got his own family, work and life to lead. The feeling in the session was both of pain and hope. But his association to the misdemeanour in the background of the dream suddenly opened a flood of other associations. He associated to some rubbishy pornographic film in which the misdemeanour was homosexuality, castration, whoring etc. In his mind he viciously turned my so-called misdemeanour into a sadistic orgy which transformed me into a lesbian, promiscuous whore. The speed, loudness and violence of the association was like a real bombardment of disjointed, aggressive and sexual elements. This time, when I pointed it out to him he became quieter and he left the session feeling sad. He said, ‘It is very sad that even at the end of my analysis you still have to watch

21 Not her real name, of course, but the first name is close to mine and the surname contains the syllable ‘cool’. 22 See the ‘Acting on phantasy and acting on desire’ paper in this book (Chapter 9).

23

Yesterday, today and tomorrow so carefully the limits.’ This kind of behaviour in the sessions raised, of course, doubts in my mind that he was ready for ending. It was also clear, however, that any weakness on my part in changing the date would mean for him a complete triumph of his madness not only over his mind but also mine. It was also significant that in this phase of his analysis there was no acting out and the madness was confined to the sessions and the dreams. I was uncertain, however, up to the last session. Though I was aware of the power of projection of his own uncertainty and uncertainty remained because the very fact of such a projection was disturbing. He did finish his analysis and for a time things seemed to go well. He wrote to me one year after the termination to tell me how he was. Unfortunately, he had to cope with an extremely painful external situation which he coped with very well and he was neither thrown into a mania or a depression and so was very grateful for his analysis. So far so good, but in my mind some uncertainty about the future remains and this I suppose refers not to my patient only. However much Freud discovered and however much others after him have extended our knoweldge, there is still more we do not know about the unconsicous and its manifestation in dreams. Our only certainty is that uncertainty still remains.

Postscript 2006 First, I am glad to state that the future of my patient is less uncertain now in my mind. I hear occasionally from him and about him and despite some very difficult external circumstances he seems to be doing very well. As to the paper itself, I don’t think my views have altered in any significant way. Maybe I should have said more about what I meant by ‘working through’ and ‘wish fulfilment’. I think dream work is a reparative endeavour in the internal world – an attempt to restore destroyed objects and aspects of oneself.This work is attacked and distorted by psychotic processes.These processes may affect the dream itself or the dreamer may produce a dream helpful to the reparative process but then he attacks it in the way he brings it to the session. I think it is also important that dreams are visual and the appearance of speech is very rare. Much of what I could say about dreams I pursue in my paper on ‘Vision’. 24

2 Disillusionment: the stor y of Adam and Eve and that of Lucifer

Psychoanalysis has often been described as the completion of mourning. But it is a twofold mourning: one is the mourning of separation and loss of real objects; but it is also, and for some patients predominantly, a mourning for lost illusions.This process starts from the very beginning. The first meeting with the analyst may offer a relief from paranoid anxieties, but, in so far as hope of an idealised object is concerned, the first meeting is already a disillusion.And this process more or less evidently continues throughout; but it comes particularly to the fore in two circumstances: one is the emerging from psychotic episodes and the other is approaching the end of analysis, in both psychotic and non-psychotic patients alike.At those moments, when disillusionment is acute, I have often been reminded of two different stories of a fall from grace. One is the Fall of Man and concerns Adam and Eve, and the other is the Fall of the Archangel Lucifer and his transformation into Satan. Of the two, the first one is simpler, and in a way less controversial.Adam and Eve ate the fruit of the Tree of Knowledge of Good and Evil. This brings with it the awareness of guilt and shame, and the discovery leads to the loss of Paradise. It is the discovery of parental sexuality and of ambivalence. It is also the discovery of death. In Genesis, God warns Adam and Eve that to eat of this Tree will bring about death. And what is their terrible punishment? They are condemned to work by the sweat of their brow and to procreate in pain. One can ask, ‘What sort of punishment is that?’ They are condemned to nothing more than to live a normal life. In fact, in 25

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Freud’s eyes, to be able to work and to love is what makes a happy life. So they lose their illusions – immortality and absence of aggression – but in exchange they are given a life. One could look at it as a great gift. But, for some people it is not a gift, but a deadly disaster. Approaching the end of analysis, the predominant feeling may be Is that all? I have heard exactly this expression, Is that all? from several patients, some psychotic, some non-psychotic.This attitude can result in a sort of permanent grudge and sourness.At the end of the psychoanalysis, will none of their conscious or unconscious illusions be fulfilled? They will just be themselves.This is the Fall of Man. There are two possible outcomes when this disillusionment cannot be accepted. One is a permanent resentment against life, giving rise to a sour and grudging attitude, with a hidden psychotic, paranoid nexus; but the other, more acute outcome, can be a relapse into psychosis, which I suggest is a move from the Adam and Eve story to the Lucifer story – a descent into Hell. What is this Paradise that patients have to give up when they finish their analysis? The Bible is not very informative on the subject, but John Milton’s Paradise Lost is. The Paradise is a delight for all the senses. There is beauty all around – warmth, oral desires, oral satisfactions, including nectar – and there is even sex. In Books I and VIII there are touching descriptions of Adam and Eve’s conjugal happiness which include a spiritual dimension as well as enjoyable daily work.The striking feature is, however, an air of unreality and a lack of passion.The food is all fruit and is uncooked, there is no meat, and the sex is idealised and contrasts with the passionate coupling described after the apple has been eaten. Even the work consists of little more than pruning and tidying up some of the plants so amply provided. Nevertheless, even in this paradise there are signs of Adam’s potential independence even though for the most part he willingly accepts the facts of life as they are handed down to him from Raphael the Angel who is sent to instruct and warn him of the dangers of disobedience. He particularly wants to explain his experience of passion to Raphael and he does not entirely accept the heavenly ethos of hierarchy because he treats Eve with full equality: . . . yet when I approach Her loveliness, so absolute she seems 26

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And in her self compleat, so well to know Her own, that what she wills to do or say, Seems wisest, vertuousest, discreetest, best; (Book VIII, lines 546–50) Despite the prevailing attitude of male superiority put forward by Raphael,Adam demonstrates that he has a mind of his own. He shows Raphael that in true reciprocal passion there is no room for hierarchy. In my own patients, the Paradise is usually linked with the phantasy of being inside mother’s body, in two different ways: one is a feeling of at-one-ness – a fusion in which the infant’s idealised version is of being immersed in and fused with the womb.The other version of Paradise which I often encounter is also a view of the inside of mother’s body, as Milton describes it – a paradise of emotional and sensual pleasures, but involving many children in the womb and free sex between them. Why, given such joys, did Adam and Eve lose it all by eating from the Tree of Knowledge of Good and Evil? In the real world in which we live, Paradise has to be given up because the reality of the experience of separation, hunger and deprivation constantly impinges on us and gives rise to rage. But there is also another reason – the powerful wish to know. In the dialogue between Adam, Eve and the Angel Raphael, Adam constantly asks, ‘How was the World made?’, ‘How did You come to be?’, ‘What is it like for Angels?’ and particularly, ‘What is it like sexually? Don’t they miss intercoursing together in a physical way?’ And Raphael explains to them that the spiritual union among angels has the same joys: if Spirits embrace, Total they mix, union of pure with pure Desiring . . . (Book VIII, lines 626–8) Adam’s questions remind me of small children, asking where they came from, fully aware of their own sexual impulses and activities, sometimes including sexual games, and yet constantly wanting to know how the parents do it. But it is not sexuality only. Klein, Bion and I too believe the impulse to know reality – what Klein calls the epistemophilic instinct – is a powerful positive force, and the impact 27

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of reality is experienced ambivalently: in one way it is hated – the loss of paradise – but it also arouses a great wish to know. This wish to know can be – and nearly always is – linked both with loving impulses and with envious, jealous and hostile ones, since this reality acquaints us with separateness, separation and subjects us to jealousy and envy. Towards the end of her analysis, a patient of mine had what she described as a ‘science-fiction’ dream: She was in a building, and there were a lot of other people, some of them rushing in looking for something like a spaceship. She felt rather isolated, and out of it. She would like to have been part of this busy group of people who pay no attention to her. Finally, somebody did respond to her queries about where all those people were going, saying, ‘They are all going to a conflict-free area’. She hesitates a moment and then decides against joining them, and comes out of the building another way. This patient often felt excluded from some (usually intellectual) elite and wanted to be part of it. In various ways, to be part of my circle, or actually inside me, and part of me, was her idea of Paradise. However, in the dream, and mostly in reality, she gives it up: she does not want to be ‘spaced out’. She is one of the patients who said so poignantly, ‘Is that all?’. At the end of her analysis she would just be herself, with her own abilities and potential and neither a part of me nor me. At a deep level we all long for this ‘conflict-free area’. But the question is how we deal with that longing.

Case material Another patient of mine tried to live in fusion with an idealised version of me and had an almost identical dream, where he was invited to enter an idealised ship. He hesitated for a moment knowing he shouldn’t desert his family but in the end he did take the ship. That patient found his disillusions very difficult. He dreamt: That he met G. (who usually represented my son) at a meeting and commented to him ‘Your mother must have been a very dominant figure in your family.’ And G. said ‘Not at all. My parents always worked together in the basement.’ G. represented that part of the patient that was aware of me as a couple:

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Papers from 2000–2006 sexually but not only sexual; working together in the basement of his unconscious. And he remembered early dreams in the analysis, in which the basement often figured, always representing something very destructive. It was either a terrible fight going on, or a brothel scene; it was often full of corpses. So the dream represented a change of his perception of me, as a couple in the analysis, in his basement. In the next session he came full of fury which he couldn’t understand and his bad mood continued for a few days. He told me that as soon as he put his eyes on me he dreaded the fury coming back. This was his reaction to a clear realisation of his ambivalence to the parental couple in his basement. I deprived him of his one-to-one paradise with me and to the end of his analysis he still dreaded that that rage might destroy all that we had achieved.

The Tree of Knowledge, Raphael tells Adam, has been seeded by the Tree of Life. It is indeed life-promoting to know reality and to know oneself – the good and the evil. But, paradoxically, eating from it gives us also the knowledge of death.That is part of reality, part of being human. But the wish to know, in its destructive aspects, turns into omniscience, omnipotence and destruction. The Serpent, tempting Adam and Eve, tempts them by appealing to their destructive part – to their envy of God and their wish for power.And that is the Lucifer part of the story. The story of Lucifer, the Fallen Angel, is more complex and does not really belong to the Old Testament, but was developed in the Middle Ages from a myth attributed to the Christian theologian Origenes.Two classical works, Dante’s Inferno23 and Milton’s Paradise Lost are based on this myth and, for both of them, Lucifer’s Fall antecedes that of Adam and Eve’s. Dante places Lucifer at the bottom of the Ninth Circle of Hell. In the previous Circles, sins were sins of appetites; but the Ninth Circle contains sins which include Evil Will.The nearest preceding Circles have violence and fraudulence, but in the Ninth Circle violence and fraudulence are combined with Evil Will, which arises out of pride and envy.The Circle is guarded by fallen Angels, giants who rebelled against Zeus, and Nimrod, who engineered the Tower of Babel – all 23 Dante, A. 1314.

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of them are envious of God.Virgil (our guide through Dante’s Inferno) speaks of the ‘beast of pride’.At the bottom, upside down, trapped in ice, is Lucifer, the most beautiful of Angels turned into the most foul. Virgil introduces him as ‘the King of the vast kingdom of all grief ’. He has wings like an Angel’s, but they become bat-wings; the Divine Trinity becomes three monstrous heads. Each of these heads crushes a sinner, but there is no doubt that he himself is in perpetual pain: he suffers the same agonies as his victims. He is weeping perpetually. What is striking in the depiction is the reversal: he is upside-down. It is a reversal and a perversion – everything is perverted.And the three sinners in the Lower Hell are Judas, Brutus and Cassius. They turn against their benefactors – their sin is ingratitude.You are all aware, I am sure, of Klein’s Envy and Gratitude24 – the implementation of the perpetual conflict between the life and death instincts. Dante and Milton have the same mythical Lucifer. But Milton gives us his complete history, including all his conflicts. Lucifer is usually seen as the personification of evil but the story of Lucifer as related by Milton is different. John Milton’s Lucifer is very human. With enormous compassion, Milton describes what led him to fall into Hell in the first place and secondly what prevented his return. Lucifer rebelled against God and his motivation was envy of God. But Milton shows that he was sorely provoked by the way God displaced him, formerly the brightest of Angels, with his new begotten son.To the assembled Angels God proclaims: Hear all ye Angels, Progeny of Light, Thrones, Dominations, Princedoms,Virtues, Powers, Hear my Decree, which unrevok’t shall stand. This day I have begot whom I declare My only Son, and on this holy Hill Him have anointed, whom ye now behold At my right hand; your Head I him appoint; And by my Self have sworn to him shall bow All knees in Heav’n, and shall confess him Lord: Under his great Vice-regent Reign abide United as one individual Soul

24 Klein, M. 1957.

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For ever happy: him who disobeys Me disobeys, breaks union, and that day Cast out from God and blessed vision, falls Into utter darkness, deep engulf, his place Ordained without redemption, without end. So spake th’ Omnipotent, and with his words All seemed well pleased, all seemed, but were not all. (Book V, lines 600–17) How could Lucifer be pleased? It was difficult enough to bow to the father and now the same submission is demanded to the brother. When he rebels he is no longer known as Lucifer: But not so Waked SATAN, so call him now, his former name Is heard no more in Heav’n; he of the first, If not the first Arch-Angel, great in Power, In favour and pre-eminence, yet fraught With envy against the Son of God, that day Honoured by his great Father, and proclaimed MESSIAH King anointed, could not bear Through pride, that sight, and thought himself impaired. Deep malice thence conceiving & disdain, (Book V, lines 657–66) Satan makes it clear as he speaks to his lieutenant, that he sees such submission as ‘prostration vile’: Receive him coming to receive from us Knee-tribute yet unpaid, prostration vile, Too much to one, but double how endur’d, To one and to his image now proclaim’d? But what if better counsels might erect Our minds and teach us to cast off this Yoke? Will ye submit your necks, and chuse to bend The supple knee? Ye will not, if I trust To know ye right, (Book V, lines 781–9) 31

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A terrible war is unleashed in which Lucifer is seen as a formidable foe who even invents dynamite, but the outcome is never in doubt and the battle ends with expulsion from heaven: Nine dayes they fell; confounded CHAOS roar’d, And felt tenfold confusion in thir fall Through his wilde Anarchie, so huge a rout Incumber’d him with ruin: Hell at last Yawning receav’d them whole, and on them clos’d. (Book VI, lines 871–5) God expels him from Heaven into Chaos, but in this Chaos Lucifer turns defeat into triumph: he gets an area of his own – he organises Hell. Farewell happy Fields Where Joy for ever dwells: Hail horrours, hail Infernal world, and thou profoundest Hell Receive thy new Possessor: One who brings A mind not to be chang’d by Place or Time. The mind is its own place, and in itself Can make a Heav’n of Hell, a Hell of Heav’n. What matter where, if I be still the same, And what I should be, all but less then he Whom Thunder hath made greater? Here at least We shall be free; th’Almighty hath not built Here for his envy, will not drive us hence: Here we may reign secure, and in my choyce To reign is worth ambition though in Hell: Better to reign in Hell, than serve in Heav’n. (Book I, lines 249–63) In this Hell Satan suffers endless pain: not only all the pains of the Hell he has created, but also a lasting pain in the memory of what he has lost. Milton differentiates between the pain he experiences in the Hell he has made for himself and a new pain, a depressive pain, at the loss of his good object and state of mind. There is a council of his followers who debate what to do. Lucifer’s longing and curiosity make him want to at least look at Heaven and check the rumours about the existence of another world.To do that, when he starts his 32

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journey he discovers that to reach God’s domain he has to cross Chaos again, the ‘first to wing this desolate abyss’. His motives are mixed: partly longing and hoping to regain the lost bliss; and partly wishing for war, revenge and destruction. And when he crosses the abyss he sees both the Heaven that he has lost and the new world that has been created. And he is exposed to a most acute conflict. After expelling Lucifer, God as a consolation for himself created the world. And Satan, seeing how great God’s hopes are for man, recognises that he can revenge himself best by spoiling these new pleasures. Even this aim will, however, be prevented by Jesus, since God foresaw that man would fall and that his world would need a saviour. So Lucifer is exposed again to the envy of Jesus, occupying the place he felt to be his own. But, additionally, he is consumed with admiration, envy and jealousy of humans and this new different world. The humans, according to Raphael were ‘created inferior to Angels, and were yet more favoured’. Particularly, he is enthralled and consumed with pain at the sight of Adam and Eve’s conjugal bliss.To the envy which led to his fall, jealousy is added at the discovery of parental intercourse, and together with guilt these lead to a tremendous inner struggle: His troubl’d thoughts, and from the bottom stirr The Hell within him, for within him Hell He brings, and round about him, nor from Hell One step no more than from himself can fly By change of place. (Book IV, lines 19–23) He carries an internal hell within him. And he is in a tremendous conflict because he feels that he can obtain pardon and regain some of what he had lost. But to do that, he has to face the abandonment of his pride, experienced as acute humiliation, and face guilt. But the guilt in this situation is overwhelming. It is not only a depressive guilt about the damage Lucifer has brought about ‘. . . now conscience wakes despair’. Added to that guilt is the immense persecution by a god seen as a mirror-image of himself – a god whom he dreads as triumphing over him and enjoying it: Who now triumphs, and in th’ excess of joy Sole reigning holds the Tyranny of Heav’n. (Book I, lines 123–4) 33

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Lucifer’s God is proud and envious. Lucifer thinks God forbids the Tree of Knowledge to humans because of his own envy of them.And faced with the loss of pride, dread of ambivalence and guilt, infused with persecution, Lucifer returns to Hell and declares war, the War of the Worlds alluded to in the Bible, in St John’s Revelation and described by Milton, as a war which will go on for ever. Lucifer’s strategy is to destroy God by attacking his newly-created world by perverting Adam and Eve. The story of Adam and Eve and its interaction with the story of Lucifer in Paradise Lost seems to encompass the basic human dilemmas – the struggle between the desire for Paradise and the powerful, envious, omnipotent, omniscient part of the self, which, if dominant, produces an expulsion from Paradise and the fall into Chaos – the ultimate fear of total psychotic disintegration. But Satan manages to organise a psychotic system of triumphant omnipotence, accompanied by acute paranoia, which produces a kind of stability. Beelzebub advocates retaining this state. Milton’s very human Satan is always in conflict wanting to gain his revenge but also wanting to emerge and escape from the organisation.To do this, he had to cross Chaos again, and to face the depressive position, a depressive position all the more painful because of the underlying omnipotence of the destructive forces and the terror of a terrible archaic superego, which is a mirrorimage of one’s own self. To face first falling again into chaos, and then the pains of the depressive position, requires a lot of effort and strength, particularly because in Lucifer’s world there is no good and helpful figure. The God of the Adam and Eve myth is far less cruel. He punishes them, but does not withhold his love: he goes on caring for them and their future, and even provides for a Saviour. But Lucifer’s God is as cruel and vengeful as Lucifer himself.That is a situation of no hope. Milton’s poetic and compassionate account seems to encompass the basic human dilemma. How to emerge from an omnipotent world and the hells we create for ourselves to a state of becoming truly human. This journey is particularly hard for psychotics who in their breakdowns create a hell inside and out. To emerge from psychosis they have to face more severe pains.

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Case material In a previous paper [‘Interpretation of dreams – 100 years on’] I described a patient who after many years of analysis and having changed considerably agreed on a date to finish in two years time. That patient, in an uncanny way, seemed to live out Milton’s descriptions of the obstacles to recovery and a return to sanity. In those two years he repeatedly had dreams and associations in which he was giving up his perversions, delusions and omnipotent control. They were very moving – both to him and to myself. But now and then when I drew his attention to some apparently very insignificant detail which wasn’t clear he would suddenly break out in a violent and incoherent way bombarding me with beta elements – both sexualised and aggressive – designed to blow my mind. This was in turn followed by moments of terrible guilt and despair. Milton describes how Lucifer crossing Chaos has to face the Guardian of the Gates of Hell. She is his daughter, Sin, whom he had seduced and raped and who is at the mercy of her sons who are trying to eat their way into her. My patient seemed to live this scenario. One session centred on the repair of an old clarinet. The gist of it was that he felt immensely relieved and grateful in realising how analysis was helping him to recover his potency. The next day, he had a dream of women inspecting and comparing boys’ penises. He turned our understanding of his potency problems into his very familiar scene of child abuse. He then spoke of a character in Nabokov called Melanie Vice – an attack, he thought, on Klein. He got both excited and persecuted by phantasies of me fingering, seducing and then chucking him out. He finished by telling me: ‘You told me some time ago that what you would do after the end of my analysis is no concern of mine. But it is my concern if you are a child-molester and murderer.’ This he said with almost delusional conviction. The wealth and cruelty of his pornographic phantasies sometimes made me think of Bosch’s pictures of Hell. Gradually those attacks became less frequent and the underlying motivation became clearer to him. In one of the sessions very near the end he reported a dream which troubled him. He and I were climbing a mountain. I was hanging onto the back of his jeans. He felt this was not right – I should be ahead of him. So he tried to lift me into the right position by putting his arm around my waist. But it was difficult and awkward. I fell down and he realised that someone else would help me.

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Yesterday, today and tomorrow The dream had a deep resonance and troubled him because when he first spoke of ending his analysis he had a dream of two girls climbing, and the one behind shot the one in front. For a long time he was truly terrified and at first did not report this dream. He could not visualise ending his analysis without killing me, because in his mind it meant I would be for ever a step ahead of him. We understood that the dream still represented this conflict, but there was a change in the new dream. I was not dead, someone was helping me and he was trying to remedy the situation. He also commented that he probably fails because putting his arm around my waist was still sexualising me. But the situation was not hopeless because there is someone else to help me. There is in the background not only a hurt and infantilised mother but a strong father analyst who can repair her. He has recognised that the parents and the analyst were always a step ahead of him. They lived, worked and actually gave birth to him. He has to live with that knowledge and of his own murderous feelings towards them and towards me. Unlike Lucifer he could allow himself to receive help from a father with his feet firmly placed on the ground.

What I am trying to convey is that when patients who are psychotic or fear psychosis are emerging from their madness, to regain their sanity they have to face all the torments which Milton’s Lucifer faced as he crossed Chaos.When they feel mad their envy is not directed at what they imagine – the analyst’s Godlike powers – but in the depths of their unconscious they envy the analyst’s, and other people’s, ordinary humanity.

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3 September 11

The paper was written for a Symposium held in December 2001 at University College London ‘On terror, trauma, revenge and repair: reactions to September 11th 2001 and its aftermath’. Versions of the paper were subsequently given at a number of other conferences.

One of President Bush’s first reactions was ‘Why? We are good people.’ People in other traumatic situations often have similar feelings – for example, after a volcanic eruption they may feel ‘there is somebody out to get me’ – but this is a delusion that can be resolved. In the case of a terrorist attack it is a fact – one’s worst nightmares come true. But there is another factor specific to September 11, and that is the symbolism of the twin towers and the Pentagon:‘We are all-powerful with our weapons, finance, high-tech; we can dominate you completely.’The suicide bombers sent an equally omnipotent statement: ‘I, with my little knife, can puncture your high-flying balloons and annihilate you.’ Thus we were pushed into a world of terror versus terror, disintegration and confusion. It awakened our most primitive fears for ourselves and the world group we belong to. It is the deepest fear in a disturbed infant and a schizophrenic. Bewilderment is an important element – ‘What has happened to me?’ But, soon after the immediate shock, I had another feeling – something very familiar, like Chronicle of a Death Foretold.25

25 Garcia Marquez, G. 1983.

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When I listen to Bin Laden and Bush exchanging boasts and threats, I am reminded of similar exchanges between Bush Senior and Saddam Hussein. Those who don’t remember their history are condemned to repeat it. Kissinger said of Saddam: ‘We knew he was a son of a bitch but we thought he was our son of a bitch.’We have since supported many Arab extreme fundamentalists because they were ‘our sons of bitches’.We have not learnt the lesson that it doesn’t pay. Kissinger said,‘We shall bomb Cambodia into the Stone Age.’We did and we got Pol Pot.Then we had the disturbing idea that massive bombing of Afghanistan, and then Iraq, would create a pathway to a new world of freedom, peace and democracy. Understanding history It is not only a matter of remembering history but of understanding it. Often we remember only too well past wrongs done to us, real or imagined, and search for revenge. I do not think we can understand the chaos and horror of today’s position without understanding something of its roots. In 1987 I wrote a paper, ‘Silence is the real crime’,26 about the change in our mentality with the advent of nuclear weapons. I contended that the threat of nuclear annihilation profoundly changed the nature of our collective anxieties, turning the normal fear of death and understandable aggression into the terror of actual total annihilation. I suggested that a deep psychotic process underlay our group thinking and reactions, and then addressed myself to the functioning of groups. Freud27 contended that we form groups for constructive libidinal reasons, to bind ourselves to one another and to address ourselves to reality (forces of nature), but also to solve our psychological problems – like merging our superego into a group superego which leaves us capable of committing any crimes provided they are sanctioned by the group. After 1920 he also took into consideration destructive impulses in two ways: that the constructive processes are interfered with by disruptive attacks arising from the death instinct, and that groups are formed to combat man’s destructiveness to man. 26 Segal, H. 1987. 27 Freud, S. 1921.

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After the Second World War, Bion28 suggested a more comprehensive theory of the function of the group. He considered that one of its main tasks was to contain and deal with difficulties we cannot contain in ourselves. He also spoke of two functions of the group: the work function (getting together to accomplish tasks) and the ‘basic assumption group’. He contended that we project into the group psychotic anxieties that we cannot cope with ourselves, and that one of the most important functions of the group is to contain and deal with those anxieties, giving them expression in more innocuous ways. For instance, we all thirst for revenge if we or loved ones are hurt, but it is a function of the broader group to prevent mad acts of revenge and convert them into justice, for the good of the group as a whole.

Psychotic groups All groups tend to be self-centred, narcissistic and paranoid. If individuals behaved like groups they would be classified as mad. On the whole it does not do much harm that the French think they are the cleverest in the world, the British that they are the fairest or the Americans that they are just ‘great’. But if the group becomes dominated by those mad premises, the situation becomes dangerous. When a psychotic basic assumption dominates a group (and maybe the combination of the military and the religious is the most deadly) then the whole group acts on that assumption, produces leaders who represent that madness and, through escalating projective processes, drives those leaders madder and madder and further and further away from reality. Understanding these group processes is vital. In a later paper, ‘Hiroshima, the Gulf War and after’,29 I propounded the thesis that the post-Hiroshima world was acting on a psychotic premise, with the USSR and the US-led West producing a paranoid-schizoid world, each viewing the other as an evil empire and threatening total annihilation. We entered the Cold War based on that premise, acting out typical schizoid mechanisms of splitting, projection,

28 Bion, W. 1961. 29 Segal, H. 1995.

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depersonalisation, dehumanisation and fragmentation – accompanied by the proliferation of ‘Nukespeak’, the distortion of language and outright lies.

Cold War lessons The Cold War was full of threats. It culminated in a nuclear arms race and eventually in the system called MAD (mutual assured destruction).The contention was that there would be no war because everybody was too afraid of total annihilation. But the Cold War wasn’t that cold and the nuclear threat was always there. Preparedness for war raises fear and hatred and can itself lead to war. In the same paper I also addressed myself to the threat of fundamentalism, though at that time the greatest danger seemed to come more from Christian fundamentalists. I considered the nefarious influence of born-again Christians on American policy, referring to literature longing for Armageddon in the form of nuclear war to destroy the work of the Devil (represented by Soviet Russia) – Armageddon being God’s war to cleanse the earth of all wickedness, paving the way for a bright, prosperous new order.And I am sure that Bin Laden would agree with that! Another aspect of the Cold (but not so cold) War which is of relevance today is war by proxy. There was no question of the US and Russia attacking one another directly, but elsewhere – in Vietnam and Afghanistan for example – wars and terrorist acts were conducted by proxy, leading to fragmentation and an anxiety that provided the cradle for terrorists.

Seeking a new enemy The quasi-equilibrium between the Soviet bloc and the US-led West collapsed with perestroika.We could now recognise, if only briefly, that our belief in an evil powerful enemy was in fact delusional. All sides could give up paranoia and address themselves to their own internal problems. Perestroika was a time of hope, a possibility of change of attitude. But there were many warnings that it was also a time of possible new dangers and a search for a new enemy. Giving evidence 40

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to the House of Commons Services Committee in December 1990, Edward Heath said: ‘Having got rid of the Cold War, we are now discussing ways in which NATO can be urged to rush to another part of the world in which there looks like being a problem, and saying, “Right, you must just put it right; we don’t like those people; or they don’t behave as we do . . . and so we are going to deal with it”.’ NATO went in search of a new enemy to justify its continued military power. George Kennan was shocked to discover, when visiting Western capitals, that despite the disappearance of the supposed Soviet threat (our apparent reason for keeping a nuclear arsenal) Western countries could not even conceive of nuclear disarmament. It was, he said, like an addiction. Nuclear firepower was constantly increasing.

Manic defences So what was going on? We are familiar with those moments of hope, clinically, when a paranoid patient begins to give up his delusions, or when an addict begins to give up the drug and get better. The improvement is genuine. But as they get better they have to face psychic reality. With the diminishing of omnipotence they have to face their dependence, possibly helplessness, and the fact that they are ill. With the withdrawal of projections they have to face their own destructiveness, their inner conflicts and guilt, their internal realities. Moreover, they often have to face very real losses in external reality, brought about by their illness. Formidable manic defences can be mobilised against this depressive pain, with a revival of megalomania and in its wake a return of paranoia. Similarly, when we stopped believing in the ‘evil empire’ we had to turn to our internal problems: economic decline, unemployment, guilt about the Third World. In Britain and the US in particular, we had to face the effect of our mismanagement of resources and the guilt about previous wars such as Vietnam. Fornari30 maintained in many papers that an important factor in unnecessary wars is repressed guilt and mourning about past wars.

30 Fornari, F. 1975.

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Faced with the possibility of confronting our inner realities, we turned to manic defences: triumphalism. Perestroika was felt to be the triumph of our superiority. Our nuclear mentality did not change. The megalomaniac search for power, noticed by Heath, and the addiction to the bomb, noted by Kennan, were bound to create new enemies to replace Soviet Russia – firstly, because in fact they create new enemies; secondly, because we needed a new ‘evil empire’ to avoid facing our depressive problems. During perestroika my colleagues and I described in various writings the danger of finding a new enemy – this time one we could really crush. Iraq fitted the bill because she too had lost an enemy (Iran) and had to face intolerable internal social and economic tensions.That led us to the Gulf War, with its horrendous loss of life and devastation. Apparently we won, but that pyrrhic victory was very soon forgotten and a formidable denial set in.A year afterwards, in spite of the almost daily bombing of Iraq, it was hardly ever mentioned.The power of such monumental denial is not only destructive but self-destructive; it destroys our memory, our capacity for realistic perception and all that part of us capable of insight, love, compassion and reparation.And we do not learn from experience.

Delusions of omnipotence After the Gulf War, some of us again wrote papers on the increasing danger of another war and were alarmed by a change in the pattern; triumphalism turned into a more explicit megalomania.This change is best summarised by General Powell’s statement:‘American soldiers will not be pawns in the conflict of global interests.’ If he had meant human beings are not to be used as pawns in global fights for power it would have been a most beautiful statement. But that wasn’t what was meant.What he meant was that we have such powers that we can do the work by bombs from on high. If anyone opposes us, he can be destroyed from the sky, while we remain invulnerable. That myth of invincibility was punctured on September 11, 2001 and revealed the tremendous anxiety, fear and maybe guilt underpinning the need for grandiosity that created the twin towers and the Pentagon building. I think the September 11 bombing was highly symbolic.We have 42

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been precipitated into a world of fragmentation, and at points total disintegration and psychotic terror – and also into total confusion: Who are our friends? Who are our enemies? From what quarter do we expect aggression? Old enemies, like Soviet Russia and Northern Alliance fundamentalist groups once supported by the USSR, are now our friends. Old friends could be enemies – Chechnya, for example.Are there enemies on the inside? The same confusion can be seen in the Arab world. The most primitive terror in our personal development is not ordinary death, but some vision of personal disintegration imbued with hostility.And the situation is made much worse when God comes into the equation. The fundamentalist Christian longing for Armageddon is now matched by Islamic fundamentalism. Our sanity is threatened by a delusional inner world of omnipotence and absolute evil and sainthood. Unfortunately, we also have to contend with the god of Mammon.

What next? We are again at a crossroads. Panic has subsided. Apparently we are ‘winning’ the war against the Taliban – another pyrrhic victory.At this moment we still have the choice of remembering the lesson of the Gulf War or blindly repeating our disastrous mistakes. We cannot annihilate all evil and terror without destroying ourselves because it’s a part of us. Even a ‘crusade against terrorism’ to obtain freedom and democracy is as dangerous and illusory as other fundamentalist beliefs that we will attain paradise if we destroy the evil that we attribute to others. The real battle is between insanity based on mutual projections and sanity based on truth. How is it that terrorism can get such massive support? I think part of the problem is that we submit to the tyranny of our own groups. If we project too much into our group, we surrender our own experiences and the group tyrannises us; we follow like blind sheep led to the slaughter.This does not mean that we should insulate ourselves and enjoy some superior ivory tower of our insights; we are all members of some group or other and share responsibility for what ‘our group’ does. Even when we are passive and feel detached, our apathy abandons the group to its fate. But speaking our minds takes courage because groups do not like 43

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outspoken dissenters. As Tennyson reminds us, ‘Their’s not to reason why/Their’s but to do [to kill] and die’.31 But we have minds of our own.We could say:‘Ours is to reason why, ours is to live and strive.’ I still think that silence is the real crime. Postscript 2005 It has become clear that the reasons given for the second Iraq war were as untrue as those given for the first.The real reasons for the war seem to include once again the need for an enemy. It is also clear that Bush’s agenda was both personal – implementing his father’s agenda from the previous war and triumphing over him in succeeding where his father failed – and on another level represented the interests of oil magnates, including himself, and on a broader scale global capitalism. The war against Iraq was a bit like the Crusades which Bush and Blair first talked about and reference to which was then quickly erased. Like the Crusades, the second Gulf War involved a religious fanaticism, linked with and covering up mass robbery. In Iraq no distinction was made between people resisting the invasion and people being terrorists and followers of Saddam. It is clear that the US is building an empire.The alternative for the rest of the world is either to submit or live with the threat of annihilation. In contrast to Saddam Hussein, who was a tyrant in his own country but no threat to the world, the leading countries on the Western side have infinite supplies of weapons of mass destruction. Atomic power is now spread out. Annihilation can happen or we may have centuries of total domination of an inhuman kind.When tanks were introduced my father said that you could not occupy a country for very long on horseback but you could do it very comfortably in a tank. Now it’s a hundred times worse – you can do it very comfortably from the sky. What does the future hold? It is pretty grim because global oppression which includes mass murder as well as total economic exploitation leaves desperate terrorism as almost the only weapon for the oppressed. Oppression inevitably leads to rebellion.

31 Tennyson, A. c.1880 from The Charge of the Light Brigade.

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This expanding global empire, like all such things, has to be sustained through control of the media – and this is of necessity based on a series of lies. From the humane (including psychoanalytic) point of view we are led as citizens to struggle with the unending task of exposing lies and striving for the preservation of sane human values – this is our only hope.

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4 Yesterday, today and tomor row

This paper was given on 15 November 2001 to inaugurate the establishment of the Centre for the Advancement of Psychoanalytic Studies, a new venture of the Institute of Psychoanalysis in London providing joint seminars for psychotherapists and psychoanalysts.

As this is the inaugural lecture of the series I wondered how best I could kick it off and it occurred to me that maybe the first question we might ask here is,‘Who are we? What is our identity? What is the common ground of psychoanalysis and psychoanalytic psychotherapy, and in what way do we differ from other psychotherapies and approaches? What are our basic attitudes and concepts and how have they evolved over the years?’ Being a psychoanalyst, of course I first go to our origins.Where do we come from? We know that our work is rooted in that of Freud. It is Freud who first introduced the idea of psychic reality – of the existence of psychic realities and phenomena that are just as real as the material world. For instance, the fact that I love you or hate you or think that the world is against me, is as real as and as important as physical facts that can be weighed and measured.This psychic reality can be studied and mapped in terms of its structure. Its functions can be discerned, observed and investigated in detail, like physical phenomena, but using new methods of inquiry.This psychic reality has meaning which can be understood. In his first studies32 Freud

32 Freud, S. 1893–1895.

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discovered that the hysterical symptoms, for instance, have a psychic meaning and so have dreams. The second thing that characterises our approach is recognising the existence of the unconscious. The meaning, for instance, of an hysterical symptom is not a conscious metaphor but it is unconscious. So, our basic tenets are that there is a psychic internal world and that this world is largely unconscious. A third tenet arising from the other two is the crucial importance of symbolism.We can understand unconscious meaning only through its symbolic expression.These were the basic principles – like a rough outline – the first sketch of a map but, of course, based on these principles further research revealed other features of central importance. Freud put the psyche on a ‘map’33 and described, as he saw it, its structure and the link between function and structure. There are unconscious mental phenomena, which are repressed (a function) and produce a structure of the conscious and the unconscious which is divided by repression and in symbolic communication with one another. That was then the first rough map. But as psychoanalytic work evolved and Freud’s theory of instinct underwent an evolution, by 192034 a new model emerged making certain features prominent. He introduced the notion of an internal world with a central introjected figure, the super ego. The map that he first described became, as it were, inhabited.The model changed to one in which the unconscious contained phantasies of object relationships which were vital.35 Conjointly with that, the concept of transference became also central.36 The super ego and other figures discovered later in the internal world is not a given – it is produced by such processes as introjection and projection. It becomes structuralised but is the outcome of inner dynamic processes. Those inner processes are mobilised and relived in the transference and therefore can be restructured. The claim of psychoanalysis is that we do not just remove symptoms but that the process can lead to a structural change in the personality. The basic tools of psychoanalysis became more 33 34 35 36

Freud, S. 1900. Freud, S. 1920. Freud, S. 1917. Freud, S. 1915a.

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clearly the understanding of the transference and the importance of the psychoanalytic setting. The psychoanalytic transference can develop only in the psychoanalytic setting. One cannot overestimate the importance of the psychoanalytic setting. It is only in a particular setting that we can study the evolution of the transference.The setting reflects the psychoanalyst’s frame of mind. The actual physical setting is at its best in a psychoanalyst’s consulting room which gives a quiet, fairly neutral place in which the patient can think and feel without interference from outside distractions. We know that in various psychotherapies and when working with small children or psychotics this kind of physical setting cannot always be provided. But the most important factor of the setting for mental phenomena is the analyst’s own frame of mind as reflected in the setting. The analytic attitude first described by Freud is that of suspended free-floating attention37 which is the basis of all settings. It also means psychoanalysts not ‘acting out’ in relation to the patient but providing a mind receptive to the patient’s communications, including his acting in and out. It is manifested in such factors as punctuality, reliability, stability etc.The importance of that setting was borne on me very forcibly by my first schizophrenic patient the first time he was late to a session. He came in a panic and it turned out he was afraid that, because he was late through no fault of his own, I would give him the extra time at the end. He told me that that would be catastrophic because,‘In my world you are the one person who knows the time. If you didn’t know what time it was, then all would be lost.’38 In his mind I contained his sense of reality which he had to depend on. It seems that I have made a transition from models of the mind to questions of transference setting and to questions of technique, because each model has its own implied therapeutic approach and a view of what the therapeutic factors are. Money-Kyrle describes how his thinking about it changed over the years.39 He said that whereas in his first analysis with Freud he thought that pathology was due to repression of the libido and the aim was to lift repression, ‘Where id

37 Freud, S. 1912. 38 Segal, H. 1964. 39 Money-Kyrle, R.E. 1968.

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was, there ego should be’.40 In his analysis with Klein, in London, he began to think that pathology was rooted in the conflict between love and hate and the aim was integration. In his third phase he attributed pathology to misperception. I think that the technical and therapeutic view of the time is best described by James Strachey’s model. He saw the analytic process basically as the patient projecting his over-severe super ego into the analyst and reintrojecting it, modified by the analyst’s understanding. Strachey’s basic paper,‘The nature of the therapeutic action of psychoanalysis’41 deals with the transition between Freud’s structural model and Klein. Because Klein continued Freud’s research into the nature of the internal world and object relationships, based to begin with on the psychoanalysis of children, she had the opportunity and inspiration to explore the small child directly rather than as it exists in the adult mind. I am sure you are all familiar with the way the analysis of internal object relationships brought Klein to formulate something that can be seen as a further elaboration of how this internal world is actually structured and what forces animate and lead to that particular structure. She studied the roots of the super ego in early infancy and brought the concept of the depressive position and the transition from what Abraham42 first described as part-object relationships to a perception of a separate whole mother. In her later work she introduced the concept of the paranoid-schizoid position and the transition between the paranoid-schizoid position and the depressive position. Two papers,‘A contribution to the psychogenesis of manic depressive states’43 and ‘Mourning and its relation to manic depressive states’44 brought in the concept of the depressive position, which she defined as the infant recognising the mother as a whole object.This implied not only a change of perception but also – something she doesn’t emphasise but which became more and more important in our thinking – that the infant gets in touch with ‘separateness’ from his mother. It brings with it a whole view of the world in which the infant becomes more aware of what is him, his thought and what is 40 41 42 43 44

Freud, S. 1923. Strachey, J. 1934. Abraham, K. 1927. Klein, M. 1934. Klein, M. 1940.

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the separate person, not a mirror image of himself. He discovers the reality of his ambivalent feelings and guilt about them and develops the capacity to investigate and understand the mother and parents he is related to. He is more and more able to differentiate his own phantasy from reality.With that goes a great change in the capacity to symbolise. Klein also placed the Oedipus complex as starting at that point with the recognition of the world outside. What happened before the depressive position was still uncharted territory but Klein and others, who by then worked with her, were very aware that achieving this state is the emerging from some other earlier stage which was still in mind, often interfering with this process and often regressed to. When asked at some point what she considered her most important discovery, Klein answered ‘paranoid defences against guilt’.A few years later in her paper,‘Notes on some schizoid mechanisms’45, she began to map out the preambivalent state. In her view, as you are probably familiar with, the infant emerges from the chaos of his own impulses and external reality by splitting the object and the self into an ideal and persecuting one. He lives in a phantasy world of ideal states, self and object, and a persecutory world dreaded and hated – often characterised by fragmentation.The model of the mind could still be contained in Freud’s structure but that model became much more complicated. Instead of a single unit, the super ego, it contained a variety of objects and was in a constant state of evolution – one that was never quite completed – with constant fluctuations and regressions.The transition from the paranoid-schizoid state to the depressive state of mind is an evolution from an insane world determined by misperceptions into a saner world in which internal and external are differentiated and in which conflict and ambivalence can be faced. Money-Kyrle’s view46 was that in his third stage of development he thought pathology was based on misperception and the therapeutic factor therefore would be the correcting of misperception. But in changing views of therapeutic factors, one is central and the hallmark of the psychoanalytic approach.The underlying assumption in all of them is that insight is therapeutic. In an obituary of Klein in

45 Klein, M. 1946. 46 Money-Kyrle, R.E. 1968.

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1960, written by Rosenfeld, Bion and myself,47 we wrote, ‘All scientific work has as its aim to see life “as it is”.The peculiarity of psychoanalysis lies in our belief that such an aim and its steady pursuit are restorative.’We emphasised the search for truth because we did not mean truth with a capital ‘T’ in an absolute sense. In a way it is a very simple, commonplace statement. Psychoanalysis does not offer cures but it is self-evident that the better you know yourself, and the clearer your perception of reality, the better the chance you have of achieving your aims. Certain analysts proposed that it is not the insight which is therapeutic but the object relationship. But what is usually implied is the kindness of the analyst.That one must be ‘good’ to the patient. Strachey48 specifically warns against that – trying to be a good object, playing ‘good Mummy’ only reinforces the split. I think that the analyst is a good object in the sense of being a more truthful object. And of course the reality of the analyst is very important in that.To begin with, a good analyst is better than a bad one! But insight is obviously related to object relationships. Achieving the depressive position, differentiating one’s own impulses and wishes from reality, is the basis of insight. Paradoxical though it seems, at depth, insight is unconscious. Conscious insight develops out of the depths. I think at this point I shall abandon the historical approach because the developments are at that point in my lifetime, just after the publication of Klein’s paper on the depressive position49 and just before her paper on schizoid mechanisms.50 I was introduced to Klein’s work in 1942 by Dr Fairbairn in Edinburgh who explained to me that there were two developments of Freud – Anna Freud and Melanie Klein – and he gave me two books to read: The Ego and Mechanisms of Defence51 by Anna Freud and The Psycho-Analysis of Children52 by Melanie Klein. I was immediately attracted to the second and began a search for Melanie Klein. Looking back, I wonder why the book made such an impression on me. I 47 48 49 50 51 52

Segal, H., Rosenfeld, H. and Bion, W.R. 1961. Strachey, J. 1934. Klein, M. 1940. Klein, M. 1946. Freud, A. 1936. Klein, M. 1932.

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think it was because it seemed to open up a new and fascinating world of the inner life of the child. It rang a lot of bells. For instance, when, as a medical student, I was on a train evacuating from Paris, as I was the only ‘almost’ doctor on the train, some parents asked me to look after their adolescent daughter who had a sudden schizophrenic breakdown and who, among other things, was screaming,‘I defecated my lover in the loo’. So, when I read Klein I suddenly remembered that and thought,‘Ah.This kind of thing can be understood.’ What stood out for me then was the importance of the interplay between unconscious phantasy and reality. In the case of that girl, the significance of it being an evacuation train. I think the other thing that stood out, not consciously at the time, but which left its imprint is the enormous importance of what Klein calls the epistemophilic instinct.53 When I started my analysis, it was after the publication of Klein’s major papers on the depressive position. I think that the enormous implications of that development, which links with the Oedipus complex, symbolisation and other mental processes, dominated our thinking at the time. In the depressive position, a whole change of attitude in anxieties, feelings, relationships, pictures of the world, comes about with the recognition of mother’s separateness. What happened before the depressive position was still rather uncharted territory, though Klein was very aware of something prior and different but looked at it mainly as an interference with the full development of the depressive position. The next step in my thinking was her paper on the paranoidschizoid position.54 This was like a bombshell. And yet, of course, as an analysand of Klein, I was in some way prepared for it. On the one hand it seemed something entirely new and disturbing but it also felt very familiar. It is a very short paper but one which gave a stimulus to very basic research and ample literature followed it. Projective identification is mentioned in that paper only in two footnotes and yet that new concept has become more and more central and helped us to understand psychotic processes. For instance, Money-Kyrle55 says that in his second stage he 53 Epistemophilic instinct – a drive to explore the world, to satisfy inherent curiosity. 54 Klein, M. 1946. 55 Money-Kyrle, R.E. 1968.

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understood pathology as a conflict between love and hate and that in his third stage it was due to misperceptions. But the two are linked. It is the emotional states of conflict and avoidance of conflict that stimulate projective identification and it is projective identification that distorts perception of the object and produces a delusional state. The transition between the paranoid-schizoid and the depressive state of mind is a watershed between the psychotic and the non-psychotic state of mind. In this transition, changes in symbolic functioning are of prime importance. Klein was always interested in psychotic processes and linked them also with failure to symbolise. In her analysis of Dick,56 a psychotic boy, she shows how failure of symbolism arrests the development of the ego. She attributes this failure to Dick’s excessive sadism in his phantasy of exploring his mother’s body. But what she in effect describes is a clear case of projective identification. She shows how Dick in phantasy projects sadistic faeces, urine, penis etc. This distorts his perception of his mother’s body, experiencing it as full of bad and dangerous things. Following Klein’s introduction of the concept of projective identification, I was able to apply this concept and view Dick’s disturbance and all that follows as due to massive projective identification. I saw and described the same phenomena in other psychotic and borderline patients and applied it to formulate a more comprehensive theory of symbolism.57 Klein’s paper stimulated a lot of research. She seemed to give us the possibility to attempt psychoanalysis of psychotics or borderline cases. With my first schizophrenic patient, the first difficulty I encountered was that of what is psychiatrically known as schizophrenic concrete thinking.The difficulty lay in understanding his communications as well as realising how differently he understood mine from the way my neurotic patients did. For instance, if I interpreted to him a castration anxiety, that was experienced by him simply as my castrating him. I have formulated the concept of a concrete symbolic equation in contradistinction to symbolism proper. This is exemplified by two different violinists whom I often quote.58 One was an extremely gifted, professional violinist whom I

56 Klein, M. 1930. 57 Segal, H. 1957, 1978. 58 Segal, H. 1957.

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interviewed on the ward.When I asked him why he stopped playing the violin he responded,‘Do you expect me to masturbate in public?’ At the same time, I had in analysis a young man who played the violin and for whom the violin too often represented his penis and potency, among other things.This in no way prevented him playing. For the first patient the violin was felt to be the penis, for the second it represented the penis. I suggested that symbol formation59 starts in the paranoid-schizoid state giving rise to what I called concrete symbolisation, or symbolic equations, and in the depressive position changes to becoming a symbol, which represents an object rather than being equated with it. In the paranoid-schizoid state, a part of the ego is projected outside and identified completely with the object. Symbolism is a tripartite relationship between self, the object and the symbol. When the relevant part of the ego becomes identified with the object, this tripartite relationship cannot exist. In the depressive position, the object is felt to be lost, is mourned and the symbol represents the lost object. Bion later put it succinctly,‘The infant recognises no breast, therefore a thought’.60 Jones61 contended that symbolism occurs when sublimation has failed. Klein, on the contrary, considered symbolisation as the basis of all sublimation. I suggested62 that concrete symbolisation is the basis of pathology whilst depressive symbolisation is the basis of all creativity. Briefly, concrete symbolisation is used to deny all separateness and conflict. The symbol is identified with the object so it cannot be used in its own right, whereas in depressive symbolisation, the real characteristics of the object are recognised and respected. For example, the psychotic violinist could not play the violin because it was his penis.The neurotic patient recognised the violin for what it was, though at many times it actually represented a variety of things. Work along these lines, which was also pursued by others, primarily by Rosenfeld and later by Bion, also brought about a technical change.We became more and more aware of the level of the patient’s communication.Watchful, for instance, of whether the patient’s telling of a dream was aimed at communicating with or projecting into the 59 60 61 62

Segal, H. 1957. Bion, W.R. 1962a. Jones, E. 1916. Segal, H. 1957.

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analyst.Whether the patient was using projective identification to get rid of unwanted parts of himself and interfere with, possess, attack or confuse the analyst’s mind. And our work was more and more concerned with the level of the patient’s functioning and the interplay between transference and counter-transference.The difficulty of the transition between paranoid-schizoid and depressive states was always present.Why was this transition so difficult in some cases and so much easier in others? More and more we became concerned with the pathology of the paranoid-schizoid position.To begin with it looked like ‘depressive is good, paranoid-schizoid is bad’ but it turned out things weren’t that simple. Bion was first in drawing attention to the fact that there are different paths that are followed in the paranoidschizoid position. I attributed the formation of concrete symbolisation, for instance, in Dick to excessive projective identification. Bion’s view was that it is not so, that the change between the two modes of functioning is qualitative rather than quantitative, different in nature. In his paper ‘On the differentiation between the psychotic and neurotic part of the personality’63 he suggests that in more normal projective identification, the projection is not so fragmented or violent and it is more easily withdrawn on the way to the depressive position. In the more disturbed state of pathological projective identification, a part of the ego is attacked and violently projected, fragmenting the object and creating what Bion called ‘bizarre objects’. These are fragments of the object filled with fragments of the self and imbued with extreme hostility. I think in pathological projective identification, there is also a quantitative element in the power of the omnipotence, which makes the identification so concrete and the power of the death instinct so great. It is well known that Bion later extended his work and his study of the most primitive elements of which the various structures are made. In his view, the infant from the very beginning projects into mother ‘inchoate elements of painful experience’64 (beta elements) which are felt concretely to enter into the maternal breast. A receptive mother can respond by understanding the infant’s underlying fears. If she takes appropriate action, the infant experiences it as the beta elements

63 Bion, W.R. 1957. 64 Bion, W.R. 1963.

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being contained and transformed, and the infant identifies with the mother’s capacity to contain and to transform those beta elements into what Bion calls ‘alpha-elements’.These are elements of thought, feeling, symbolisation, etc. But where there is a failure in this interchange, which Bion calls the ‘alpha function’, then beta elements persist and they cannot be used for transformation or symbolisation but can only be expelled. In this view, there are two trends of development from the beginning of the infant’s life. One along the psychotic lines, the other along non-psychotic lines. That brings a slightly different model of the mind of two parallel and conflicting developments from the start. I think, however, that they are compatible with the basic structural model and this indeed is what Freud describes in quite an early paper,‘Formulations on the two principles of mental functioning’65 which may be the most frequently quoted of Freud’s papers in post-Kleinian writings. But the work done in this area by Bion and others did bring about a revision of certain terms, for instance, repression. Freud emphasises the difference between ‘porous repression’ allowing a flexible communication between the conscious and the unconscious in symbolic terms, and ‘rigid repression’ which is a barrier. I have suggested that what Freud called rigid repression was in fact a splitting off of psychotic, insufficientlysymbolised content, so in states of illness you witness not the ‘return of the repressed’ but the ‘return of the split off ’. Bion66 extended that. He differentiates between the ‘alpha contact barrier’ which can be described as a space or function in which there is a constant transformation between beta and alpha elements, and the ‘beta screen’ which is an accumulation of beta elements. The further we go into this work the more emphasis is placed, not only by the Kleinians but by everybody working in that area, on the extreme importance of the psychotic process, which is active not only in the psychotic, but as an important part of all personalities. From the technical point of view, the moment we started taking into account the psychotic process, we started not only differentiating better between the levels of the patient’s functioning and communication, but also we took better account of our counter-transference.You will

65 Freud, S. 1911a. 66 Bion, W.R. 1962b.

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have noticed that I only spoke up to now about transference. Nowadays, you seldom hear transference spoken of alone.You usually speak about transference and counter-transference. If projective identification is of such importance, the experience in the countertransference of those powerful projections is equally important. Bion’s theory,67 which deals with the differentiation between psychotic and non-psychotic development in the container/contained relationship,68 provides a theoretical model in which the reaction of the analyst to the patient is to be constantly taken into account. In Bion’s view, projective identification is not only an omnipotent phantasy in the infant’s mind but also its first means of communication. It does affect the mother and her response to it is of the utmost importance. I shall illustrate some of the changes in technique which came about as a result of increased awareness of the interplay between transference and counter-transference by saying something about my own experience.

Case material My third paper, ‘A note on schizoid mechanisms underlying phobia formation’69 relates to a borderline, severely hypochondriachal and phobic patient. In one session, approaching the weekend, she started the session by telling me that she had had a terrible night with scattered dreams filling the room. She remembered thinking, ‘God, don’t let me be hungry,’ and woke up thinking ‘I scatter, I splutter and I sink.’ She told me a fragment of her dream and I interpreted it on the basis of previous material and the content of the dream as a projective identification. After that the session was filled with her dreams in the following pattern. I would interpret the obvious projective identification in a fragment of a dream, for instance, in a dream about puppets and another one later about peeing into the soup. Each time I interpreted it in the transference, she would immediately tell me another dream. This filled the session. Each time I took her dream as a confirmation of my interpretation and felt quite

67 Bion, W.R. 1957. 68 Bion, W.R. 1962b. 69 Segal, H. 1954.

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Yesterday, today and tomorrow pleased when she gave me more and more material. In the last session before a weekend, we were concerned with her need to idealise me. Over the break she experienced a paralysing fit of phobia of crowds. Again I took it as a confirmation of my interpretation and interpreted the clear pattern of how, when faced with hunger, in her fury she split herself, throwing fragments of herself into me and into the people who came together as an attacking crowd. The crowd represented to her agglomerated fragments of me, as her associations to the event made quite clear. I think I interpreted to her quite correctly the processes and described clearly the schizoid mechanisms of fragmentation, projective identification, re-introjection and the psychotic structure that was contained in the neurotic symptom of phobia. But I treated it as the patient’s omnipotent phantasy – I had missed completely the fact that this was totally enacted in the session filled with dreams – and that I was completely controlled by her. Each time I made an interpretation she would immediately identify with it and take it over. She was feeding me titbits of dream in a very seductive way which made us identical – my functioning reflecting herself. Although I strongly interpreted her wish to control and the hostility implied in it, I had completely missed that it was actually happening in the session. I am amazed, looking back on it, at the complacency in my counter-transference (I would see it very differently today) and through that omission, I provided no containment whatsoever. Not only was she fragmented but she experienced me as equally fragmented, superficially libidinised but full of hostility. I think the phobia taking a form of the crowd has to do with the fact that beta elements cannot be integrated – only amalgamated. So this was not a confirmation of my clever interpretations, but an acting out through lack of containment. The second case I want to refer to is from my paper ‘Depression in the schizophrenic’.70 It shows a successful clue from the counter-transference. A girl who was increasingly psychotic from the age of about 4 came to me at 16, after years of chronic hebephrenia.71 Most of the time her communications were not understandable. She could be silent for weeks or talk disconnectedly and uninterruptedly. At some point, after weeks of

70 Segal, H. 1956 71 Hebephrenia is disorganised behaviour with inappropriate affective expression characteristic of a type of schizophrenia.

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Papers from 2000–2006 her rushing around and screaming in the room she made references to skeletons falling out of cupboards. I understood it as a typically schizophrenic communication about secrets in the family and I knew that the secret was the suicide of her father which she had not been not told about. She obviously heard that interpretation and suddenly became sad. In the next session her dancing in the room was accompanied by constant gestures of scattering something around the room and became somewhat more attractive than her previous rushing about. I felt suddenly invaded by a wave of depression and helplessness. The more cheerful her dance became, the more gloomy I got. Suddenly, it occurred to me that it was like watching Ophelia on the stage. I said, ‘It seems to me that you are being Ophelia’ (I knew that in her sane intervals she read Shakespeare as a Bible). She immediately stopped and said, ‘Yes, of course’ and then sadly, ‘Ophelia was mad, wasn’t she?’ It was the first time I had a sane communication from her. So I interpreted to her how she couldn’t bear, in the previous session, the thought about her father’s death and how she broke up her mind into little pieces (the scattering behaviour), linking it with naming of the flowers and throwing them into me. The rest of the session was quite quiet and thoughtful. In this case, I understood her actions in the session, their effect on me and my understanding provided a container.

I knew it intuitively because my paper72 was published before Bion provided the concept of bizarre objects,73 I think a year before, and quite a while before the formulation of the container/contained theory.74 Indeed, what was very amusing was the fact that when I showed Bion the first draft of this paper, he suggested that I throw out the references to the counter-transference because people weren’t interested in the analyst’s feelings, but only in what was relevant to the patient. But he obviously changed his views not so many years later. I am giving this example to show how the final formulation of our theories is something that has been arrived at and developed slowly over the years in the work that we are all doing clinically with neurotics as well as with psychotics. But, as with all new things, we

72 Segal, H. 1956. 73 Bion, W.R. 1957. 74 Bion, W.R. 1959.

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must be careful with counter-transference and constantly keep in mind that it is, as I often say, the best of servants but the worst of masters. So far I have spoken of the past. It has been suggested to me that I should talk to you also about my ideas for the future.What are our current and future areas of research? It seems to me that it becomes more and more prominent that what we have to pay attention to is the power of the psychotic part of the personality. In our work, we must be aware of that constant struggle in the patient’s mind and our own with these powerful forces. Reverting back to Freud, one could say there are two principles of mental functioning, but that is not only the pleasure principle and the reality principle.The pleasure principle is not simply a libidinal search for pleasure. I think it is the principle of omnipotence imbued with a terrible hatred of reality, internal as well as external. While the reality principle is in fact more imbued with the life instinct – wanting to know and preserve the reality of life.The implications for technique are enormous – the stability of the setting is a reality constantly attacked by the disruptive psychotic forces with which the analyst struggles not to collude, particularly in the setting of his own mind. In today’s political and social realities, we seem to live in a blocked system of mutual projective identification imbued with deadly hostility and I think we must be more than ever aware of the power of these forces. There is a lot of research about mental life in many important and interesting fields but I think we must remember that psychoanalytic theories are forged in our clinical work. However much we may be interested in, and try to communicate with, other kinds of research, our own laboratory is always the psychoanalytic setting and the psychoanalytic research into people’s minds.

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5 Vision

Segal’s ideas on voyeurism are well known through her discussions and supervisions, but this is her first paper on the subject. This 2004 paper has not been previously presented and is published here for the first time.

Some 50 years ago in Buenos Aires, Henri Pichon Riviere, a psychiatrist and one of the pioneers of the psychoanalysis of psychotics, showed me his hospital’s collection of psychotic paintings and drawings. He drew my attention to the fact that in nearly all of them there was a representation of an eye or eyes – often either fragmented or hidden.This interested me at the time but it didn’t lead any further. Over the years, however, I noticed more and more the crucial role of voyeurism in psychotic functioning. The link between perversions and psychosis is well established, as is the role of psychotic concrete projective identification. It has struck me, however, that among the perversions voyeurism seems to play a crucial part in the shift between psychotic and non-psychotic functioning. More and more often I remembered Henri Pichon Riviere and began to think that in every shift from neurosis to psychosis there is, however fragmented or hidden, the powerful impact of seeing. In a way it isn’t surprising. Seeing the world and ourselves as we are is sanity, distorting the vision takes us into the world of hallucinosis.With psychotic patients I often observed that a breakdown was preceded by an increase in voyeuristic activities and that being aware of that in time could frequently, in my experience, prevent an outbreak of psychosis and enable it to be contained in the session. There is always a battle going on between healthy curiosity – what 61

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Klein called the epistemophilic instinct – the need to explore (one could also look at it as reality testing) which is very close to and in constant conflict with voyeurism, which distorts and perverts it.

Case material A psychotic patient I have in mind was a young engineer who had been a very curious child who always wanted to know how things worked, a valuable attribute which made him a gifted engineer. However, his omnipotent, omniscient voyeurism often made him unable to see what was in front of his eyes because he wanted his eyes to penetrate inside everything, to find some hidden secret which would make him feel omniscient and which was also distorting because with his eyes he wanted to control everything and make it be what he wanted it to be. He often said about his dreams, ‘I want it to mean. . . .’ The voyeurism was linked with exhibitionism, which to begin with was more in evidence. In the very first session he complained about the size of his penis and after some innocuous interpretation about feeling small on the couch in the position of a patient he grabbed his crotch and said, ‘I will show you’. We soon discovered what magic he attributed to his eyes as he described his relationship to his girlfriend. He spoke of their spending hours just looking into each other’s eyes. He also believed that if he looked at women in a particular way he could implant in them an insatiable need for himself. He was forever watching me but his distortions were such, even in the psychosis-free intervals, that he once admitted he wasn’t sure he would recognise me in the street. Similarly with the room. He could notice a speck of dust or some part of furniture being shifted a bit but he could look at a picture I had had for ten years and ask me if it was new. Similarly, he had seen my husband frequently in the street and yet when I had a Rouault caricature, The Pedagogue in the Room, which bears no relation whatsoever to how my husband looked, he was convinced it was his portrait. He was also convinced that he saw him kissing a blonde in the car, etc., etc. The underlying position was quite clearly that he could not bear any situation of smallness, dependence, jealousy and particularly of envy and was forever reversing the position. But the most hidden and powerful projection and identification happened through the eyes. He was in enormous conflict with exhibitionism because

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Papers from 2000–2006 on the one hand the whole point of this stealing and reversal was to become an object of envy but he was also terrified of it. Being seen through was his greatest terror. It was revealed to me quite early in his analysis when I made a wrong interpretation. He was describing a terrifying dream in which there was turmoil and infinite storms all around him. But he was standing in a still place under the eye of the storm. As, at the beginning of the session, he threw himself on the couch with tremendous relief I interpreted to him that the still eye of the storm was the peaceful place on the couch. He nearly jumped off the couch and almost out of his skin with horror saying, ‘Don’t you understand that to be seen by the eye of the storm is the greatest terror I can imagine.’ So in his exhibitionism he wanted me to watch and to see what he wanted me to see, while totally terrified of being seen through and particularly of me seeing the way his eye on me was the eye of a god. The session that was an important turning point was when he had suddenly realised with complete despair that he thought he had managed to turn his analysis into a peep show in which he and I were watching together, excitedly, an increasingly terrifying pornographic show and ignored the reality. His pathology was very complex and in many ways he was genuinely cooperative and striving very hard. It was only slowly that the destructive role of his voyeurism came fully to the fore and, looking back, I think that it was the analysis of that particular aspect that made the greatest impact. Another case I have in mind, this time a case I sporadically supervised, was that of a late middle-aged professor who had multiple perversions from which I can’t say he suffered. Many of the perversions were faecal and his mouth smelled of faeces to an incredible degree. The analyst had to keep the window open for ten minutes after his session to air the room. The patient was completely oblivious to the symptom and positively enjoyed the analysis of his multiple perversions. In a way he could be seen as quite cooperative although in fact he was emotionally completely withdrawn. His curiosity was only evident in relation to psychoanalytic theories and he was an insatiable reader of psychoanalytic literature. His voyeurism came violently into the material at a time when I visited his country and he came to a meeting at which I was the speaker and his analyst was the chairman. The patient went into a kind of orgy where he watched our every move and contact and was obviously projectively identified with a distorted view of our partnership. He also started thinking of having analytic training (he had had previously some six weeks of

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Yesterday, today and tomorrow Lacanian analysis which, in the scheme of things, meant he could present himself as a Lacanian analyst) and in fact he had a few patients. His idea of having a training analysis, he explained, was that he and the analyst would listen to his dreams and material and then discuss it together. (Not unlike the view of my psychotic patient except that this one had insight about it and felt despairing while the professor thought with complacency that is how it should be.) He also had a dream at that time in which he had a magic camera in his belly that not only could see and photograph anything with X-rays but could also distort it as he wished. After some weeks, during which the work was mainly centred on his voyeurism and exhibitionism, he had a dream before a weekend. He dreamt that he was crossing a bridge but the second half of the bridge ahead of him was in a mist and he couldn’t see. His first association was very subdued: ‘For the first time I realise I actually don’t see, don’t know where you are going for your weekend.’ The striking thing was that the next day he brought to the session a deodorant with which he sprinkled his mouth and eventually the smell from his mouth disappeared. I don’t know precisely what the link was, but it was the analysis of his looking that seemed to affect the faecal perversions which had not been touched by all the previous analysis on an anal level. He also became acutely aware of the difference between healthy curiosity and perverse curiosity. He of course took it over in his professorial way, frequently pointing out to the analyst, ‘Don’t forget that there are two ways of being curious.’

It struck me in the literature that there is quite a similarity between the material Ruth Malcolm75 described and the more recent case of a child analysis by Judith Jackson.76 Both describe a turning point between curiosity and voyeurism. Ruth Malcolm’s female patient had had psychotic breakdowns in the past.After Malcolm had successfully analysed her major projective identifications, the patient told her about her recurring masturbatory phantasy.There is a stage on which perverse sex of various kinds is happening and there is a crowd of people watching but one by one they get excited and climb on the platform to become part of the scene. In the end all the observers

75 Riesenberg Malcolm, R. 1999. 76 Jackson, J. 2000.

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become participants. In that phantasy she is the observer of parental sex but obviously her projections are distorting it, making it into a sado-masochistic scene. She projects more and more onto the stage, gets more and more drawn into it and the observing ego disappears. I think the disappearance of the observing self is the moment sanity is lost. This is even clearer in Judith Jackson’s case, a latency boy referred to analysis because of uncontrollable aggressive behaviour. In the consulting room he would either abuse her verbally or throw things around and physically attack her. He was incapable of playing or relating to her as a person. After some months he developed a play which in itself seemed a step forward. In his play he would arrange two toy football teams and he was a reporter loudly reporting the game.The reporter got more and more excited and eventually started shouting and at that point the boy abandoned the play and resumed his mindless aggressive behaviour. Obviously, the reporter was partly his identification of the analyst objectively reporting the violent rivalries represented by the game but gradually the child got more and more excited, like the observers in the adult masturbatory phantasy, and with this voyeuristic excitement taking over, the sane reporting was lost and psychotic behaviour broke out.

Case material The most recent and slightly more detailed material that I want to present comes from a young woman suffering from bulimia with one fairly severe episode of anorexia. She is very split in that she can be very cooperative and function quite well in various ways but she can also be very manic and at times very cut off and withdrawn. The material is dominated by terror of separation and separateness against which she struggles by manic domination of narcissistic withdrawal. That withdrawal mostly takes the form of a phantasy of being inside me in total control, simultaneously a baby inside nourished umbilically and in total possession of mother and a pregnant mother who is seen almost like that baby, glorying in her state and served by everybody. Eroticisation is a constant feature and so is a battle for control. She apparently doesn’t show any curiosity about me. In fact she doesn’t want to know anything about me – she often reiterates that and yet she used to come terribly early, hang about in the street and

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Yesterday, today and tomorrow be very frightened of me accusing her of being intrusive. Apart from general control she is very preoccupied with omniscience. She sees me as omniscient and withholding knowledge from her sadistically and is forever in search of possessing that omniscience. For instance, she fell in love with a man mostly on the basis that she thought he ‘knew all about Klein’ and she made sure he fell in love with her. She is extremely preoccupied with her appearance and can never find the right clothes – mostly because she feels that she gets into somebody else’s shoes or clothes. Like the psychotic patient I described she is both very exhibitionistic and vain and at the same time terrified of being seen through. The session I want to present happened around the time of her birthday which is a few days before the Easter break – seen in her culture as the main festival of new life/birth – ‘that other baby’. The day before the session I want to talk about we spoke mostly of her birthday, mainly in terms of her feeling thrown out of her favourite position inside me and her dissatisfaction with all the presents she received, particularly from her parents. She contended in the past that they always gave her the wrong gifts. But towards the end of this session she also told me she wore a shirt that her father gave her years ago which she had never worn and yet it fitted her so well and she appreciated its warmth and its colours. So I interpreted to her that she always presented her birthday as a catastrophic exile but maybe now she feels more that a birthday could also be seen as a gift of love – keeping comfortable and warm in that shirt she was given. She was completely dumbfounded by this interpretation. She said she never even imagined being able to think like that. I didn’t at that point interpret to her, but I did in a later session, that it was also a gift from her father to her mother. Had I made this interpretation at that point I think it would have been very provocative. The next day she started by telling me that she saw me outside the consulting room as I was walking towards it and opening the door. It was a great shock to her to see me outside. She explained at great length why she came so early and how frightened she was to think I would see her and think her curious and intruding. I pointed out to her that a few weeks ago she complained bitterly that in all the years she had come to analysis she had actually seen me for no more than an hour or two. And yet now when she had an opportunity see me for a longer time she was so concerned about being seen, it seemed she hadn’t seen me at all. She agreed with the fact that she hardly looked at me. Then she described how self-conscious she was the day before when she had to

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Papers from 2000–2006 wait for a few minutes before an interview and there in the same waiting room was a man waiting for his interview. He was sitting there quietly unconcerned while she was jittery and went out of the waiting room, came back again, etc. I asked her if she felt self-conscious at being seen watching and she said no, that wasn’t it. She just couldn’t bear to wait a few minutes. So I interpreted to her that it was unbearable for me to exist outside the room and that she thought I would accuse her of intrusion because, when presented with the sight she didn’t want to see, she would use her eyes to get right inside me again. She then said she did not use her eyes to observe me but the space in front, wanting to know what happened to the previous patient who was there. And then she spoke about a memory – many times described by her. When she was 18 months old, she was standing in her cot and her parents were going out and she screamed and screamed until she vomited and they were laughing at her before going out. It is a memory that frequently recurs and I can’t know whether she imagined they laughed (because she is very paranoid and often feels mocked) or if they actually did – they are very un-understanding parents. However, for the first time she told me something new. She said, ‘I never told you before but it is not only that I vomited but I poked my eye and actually damaged it quite severely.’ And she reported several other occasions when she managed to damage her eyes. She is very masochistic and accident prone but it is the first time that she spoke of accidents to her eyes and I realised that last week she was complaining of patches of eczema under her eyes. She then went on to speak about babies and how they comfort themselves by sucking their thumbs. I pointed out to her that this was not her case because we know that she bit her thumb very severely and didn’t suck it. Only a week before she was very preoccupied with scars under her nails which she found very disfiguring. She came back to tell me about more eye symptoms. I interpreted to her that seeing me coming reawakened the terrible rage of seeing me as separate from her – not her possession as she feels in the room – and this stimulates the violent rage so that the thumb which represents my feeding nipple gets bitten off and her eyes penetrate and attack me. Biting her thumb and using her eyes to get inside me with rage. She was silent for a while and then said, ‘This is funny. I dreamt last night that I went to my doctor to ask him if anything could be done about the scars under my thumbs and he asked me whether I had any eye symptoms.’ The relation of that patient to her eyes is very complex. She attacks her eyes on the

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Yesterday, today and tomorrow principle, ‘If thine eye offend thee, pluck it out’.77 She also attacks the eye that sees her parents going away or even me coming back since it means I was away. But she also uses her eyes in a magic way to attack and distort me. Simultaneously she tries to steal an omniscience that she attributes to me and at the same time she attacks her eyes in persecutory guilt and self-punishment.

I think the particular importance of vision may be related to the fact that out of all the senses vision directly presents the infant with the fact of mother’s separateness and it is that vision which is attacked, using the same sensory channel for projective identification, and the eyes in an omnipotent way are used to destroy the reality of the external world and create a hallucinatory world of madness.

77 Gospel of St Matthew, New Testament 18:9.

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6 Reflections on tr uth, tradition, and the psychoanalytic tradition of tr uth

This 2006 paper was written for American Imago.78 The format of Imago is to invite authors to write on controversial topics in psychoanalysis.

Truth and tradition – it’s a challenging and very broad subject to discuss. I think I would like to start by trying to define those terms and the way I am going to use them. First, the definition of ‘truth’. I think we have to discriminate between Truth (with a capital T) and truth (with a lower case t). Truth is based on a delusion that we have, or were given by some higher powers, some immutable knowledge, not to be questioned. This leads to tyranny and the destruction of different points of view and impedes all progress. One could describe it as a religious state of mind which attacks the scientific search for truth (lower case). However, this ‘religious’ state of mind is not only external to the scientific world but, consciously or unconsciously, interferes with the development of science. Theories are then accepted as dogma rather than subject to ongoing inquiry. But beyond the question of the state of mind associated with truth, it may be seen that truth itself refers to ‘what is’.This is the prevalent philosophical thinking on this matter. For instance there is a stone on the path – that is a fact. There are trees growing – these are facts 78 Segal, H. 2006, American Imago, 63(3): 283–92.

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which are true and the trees and stones were there before there were humans on the planet.They existed irrespective of the existence of an observer. But the scientist, of course, wants to know more than that. Why are some stones blue or red, soft or hard? What are trees made of? Why do they grow? etc. Such investigations demand new techniques. New techniques of observation reveal new facts and new facts in turn may dictate new techniques. And both the techniques and the apparently discovered facts have to be validated. Often the microscopic view alters our view of the macroscopic. For example, a new problem arose when sub-atomic research revealed that in the sub-atomic the rules which applied to the microscopic don’t hold.At best we can describe probabilities. When we focus on the application of technique to the discovery of truth we must be aware that the presence of the observer impacts the field of study. Not only does his very presence alter the field of observation, as exemplified by Heisenberg’s Principle of Uncertainty, but the paradigms in the mind of the observer shape what can be seen by him.There is no ‘truly objective’ state of mind with which the observer simply studies ‘what is’ through the application of his techniques.79 The paradigms in the mind of the observers are based on previous theories and knowledge and in a desirable state of things would be flexible and open to correction. Often a paradigm is extended and enriched. At other times it has to be completely rejected as, for instance, the paradigm that the earth is flat and the sun moves around it. On the other hand no further chemical investigation, however minute, has ever affected the Periodic Table. I think such paradigms are an essential aspect of what we call ‘tradition’. These definitions of truth and tradition apply to the mental sciences as well and specifically to psychoanalysis. The kind of truth that concerns psychoanalysis is truth regarding the unconscious. Of course, Freud did not ‘discover’ the unconscious – many poets, writers and philosophers before him had profound insights and described very precisely the depths and complexity of human nature. But he laid the foundations and parameters of the study of this dimension of the mind as a scientific endeavour. I think therefore that it is of interest to examine his endeavour to discover truth against the

79 Kuhn, 1962.

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background of the philosophy of science and of mind that I have described here. Accordingly the problem becomes that of how to apprehend truth of the unconscious mental processes. There are obvious ascertainable truths; things that within any given culture are known through common sense. For instance, everybody can see that X is angry or excessively jealous.The researcher will want to know more.What provokes the anger? Why is A so prone to anger and B almost incapable of it? Why is C insanely jealous? etc.To find out why we need a technique of observation, and both the technique and the newly discovered facts have to be substantiated. I said that Freud laid the foundation of the study of the mind as a scientific endeavour. He limited the field of observation and took into account the fact that the field of observation is altered by the presence of the observer. He set parameters and established a setting similar to a laboratory, defining the conditions under which the investigation could be pursued with particular attention to the relationship between the patient and the observing analyst and how the process of the analysis affects the analysand. In those conditions he studied the mind and described its structure and function. He elaborated a technique: an interplay between free association and interpretation. He quickly realised that the very fact of the observer altering the field is of crucial importance and within those parameters he developed his model of the mind. I think that this model of the mind is the basic paradigm of psychoanalytic work.We do not come to the patient with an empty mind. We always have in our mind a tentative model of psychic functioning and ideas regarding how it can be accessed, understood and modified. That model we carry is internalised through our own analytic experience and clinical work. But this paradigm, the model of the mind, must be flexible. At this point another essential aspect of the term ‘tradition’ needs to be mentioned, one that is perhaps more uniquely psychoanalytic. In addition to accumulated and internalised knowledge contained in the notion of paradigm, tradition also refers to the kinds of knowledge which are relevant and meaningful within a given discourse. Here I am referring to the boundaries of paradigms that may be considered psychoanalytic in nature. In my view, psychoanalytic paradigms, or models of the mind, should not only aim to be scientifically true, but also are specifically concerned with the truth of the unconscious 71

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processes of the mind. Moreover, the method that they provide to access these processes and modify them is based on understanding and interpretation, i.e., on truth. In other words, integral to psychoanalytic tradition is an aim and method focused on the search for the truth of the unconscious, which in turn is founded on the idea that attaining such truth is in itself therapeutic. Clearly, scientific inquiry may lead to the discovery of many different kinds of truths about the mind other than truth regarding its unconscious working and it may be discovered that knowledge and mental change may be brought about in various ways other than through truth. Such findings would be scientifically valid and perhaps important for the advance of knowledge in different fields of study, but would be outside the direct concern of psychoanalysis.Tradition, in this sense of the boundaries of psychoanalytic concern, sets limits on the flexibility of the paradigms that could be developed within the field of psychoanalysis. Freud was always very flexible about the content of his paradigms. In his lifetime he altered the model from his first model – a fairly simple division between the conscious and the unconscious – to the structural model80 which I think is the basic model underlying contemporary psychoanalysis. It is graphically represented by Freud’s picture of the pyramid.That model includes function and structure and their interplay; a structure formed by the processes of projection and introjection. It shows, for instance, how the forces of the id are projected into an internal object that becomes the superego. This model brings the innovation that there is a particular structure in our internal world and that part of the ego itself is also unconscious. That basic model was challenged by the discovery of a new technique, namely the play technique developed by Melanie Klein. The analysis of small children revealed that the superego is not the only internal object. It revealed a whole phantasy world of various objects, some of them part-objects, with complex interrelationships. The superego itself, it appeared, had much earlier roots than Freud assumed and has a long history of development. Klein observed that small children express themselves primarily in play and therefore she decided to carry out their analysis in a playroom, providing a limited amount of playing material.

80 Freud, S. 1920 ‘Structural model of the mind’.

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However, with all these important developments in technique she kept to Freud’s parameters, in particular the setting, including protection from outside intrusion, regularity of the length and frequency of the sessions and proceeding by interpretation free of advice or educational interferences. Those she saw as intrusions into the analytical field. In this sense she retained a strictly psychoanalytic state of mind aimed at grasping unconscious truth and making it available to the patient. What Klein learned from her innovative work with children enabled her to see the development of the later phases described by Freud in a different light. It brought an alteration in the Freud model, not doing away with it but putting it, as it were, under a stronger microscope.This allowed for an enriched and broader understanding of the mind, culminating in what may perhaps be referred to as a ‘revolution’ in Kuhn’s81 sense of the term.At the same time, however, Freud’s basic concern with the analytic attainment of the truth of the unconscious mind was retained. Klein’s developments may be summarised as follows: At the beginning of life the infant lives in what she called the paranoid schizoid position in which he splits his objects into an ideal and a persecuted one, dominated by processes of projection and introjection in which the infant projects part of himself into the object and splits both the object and the ego into a good and persecutory object and self. As reality testing progresses and both self and object become more integrated the infants’ state of mind shifts from blissful and hellish to a real perception of the object and more awareness of his own bad impulses. This opens up a whole new set of feelings as the infant recognises his own hostile impulses omnipotently which can destroy the good and needed object. In their wake come a new awareness of guilt, loss and capacity for mourning and a mobilisation of reparative feelings aimed at restoring a good internal object. These reparative impulses then re-create what was destroyed and are the basis of creativity.This state of mind Klein called the depressive position. Throughout a lifetime there are constant fluctuations between the two positions. The shift between them is, according to Klein, a shift between psychotic and non-psychotic modes of functioning. The superego has its roots in the paranoid schizoid position but its 81 Kuhn, T.S. 1962.

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character alters in the depressive position when projections are partly withdrawn.The severity of the superego is determined by the hostile projections. Klein speaks of fluctuation and contends that the depressive position is never fully worked through. It is the structure of one mind with fluctuating changes. If the depressive position is felt as too painful to endure, a series of defences come into play to bring about a regression to the paranoid schizoid position. It may be seen that this model does not contradict Freud’s pyramid but rather highlights additional dimensions of it. But Klein’s discoveries also provided a conceptual tool for the analysis of psychotics and this in turn produced a further shift in the model. The clinical experience now included the pathology in the paranoid schizoid position itself. This was due mainly to a more detailed and deeper understanding of Klein’s concept of projective identification and led to the differentiation between concrete and more truly symbolic representation. This eventually led to a formulation of the mental functioning and structure in a slightly different way. At the time of these developments there was another trend emerging in child analysis, introduced by Anna Freud (who at the time contended that children under the age of seven could not be analysed). She insisted on the necessity of educating as well as analysing and she and her followers considered Klein’s innovations to be ‘heretical’, since they introduced changes in Freud’s technique and models of the mind.These differences came to a head in what are known as ‘The Controversial Discussions’ in the British Psycho-Analytical Society, described in detail in The Freud-Klein Controversies 1941–1945,82 edited by Pearl King and Riccardo Steiner. In my view, despite differences there existed a shared ground of psychoanalytic concern with attaining and furthering the truth of the unconscious mind that held the different groups together. I suspect that this was supported by the fact that both Melanie Klein and Anna Freud were primarily motivated by a concern for the well-being of psychoanalysis rather than by personal ambition. After those discussions, the British Society had a curriculum in which both trends were taught. Some parts of the curriculum were joint and some, mainly technical, were taught separately.The balance

82 King, P. and Steiner, R. 1991.

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was then kept by what was called the Middle Group. But nothing of course is static. In the context of the British Society of Psychoanalysis there was some constructive interaction between the groups and of course such developments were not only in the British Society but also worldwide. These developments were mainly concerned with extensions and modifications of Freud’s original model of the mind. However, there was also a development originally started by Ferenczi, but which evolved in a much subtler form later on, the basis of which is the claim that psychoanalysis is not enough and the analyst must in some way act to achieve a ‘cure’. Of course there is always pressure on the analyst to relieve the patient’s anxiety and distress by gratifying their desires for love, support and comfort.The question then arises as to whether we recognise this inevitable pressure as an important communication by the patient – a source of information about the nature of their internal world – or whether we give in to such pressures with our conscious agreement, believing this to be an effective, even superior, therapeutic approach. I consider this to be an enactment, which attacks the basic analytic setting and method. Bion’s work is a continuation of the model of the mind developed by Freud and Klein. According to Bion,83 at the beginning of life the infant projects into the maternal breast inchoate elements of experience which he calls beta elements.The mother’s unconscious reception and response to these projections in an understanding way converts them into alpha elements. He called this the alpha function and this is a function which the infant introjects. From the beginning of life this is a continuous process in which there are parallel developments – the beta elements remain concrete producing what he calls a beta barrier.The alpha elements become elements of symbolism and the basis of thought and creativity and further development. In the depths of the unconscious there is a constant transformation of beta into alpha function. In that model, what Freud called fixation points are split off beta elements.These transformations come to a peak in the depressive position. In Bion’s model the Freud and Klein models are not overthrown but modified. Not only are many of their insights and discoveries regarding the functioning of the mind retained, but more importantly the basic psychoanalytic object of study, the 83 Bion, W.R. 1963.

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truth of the unconscious processes of the mind, remains at the heart of his work. This continuity from Freud, through Klein to Bion is reflected in the evolution of their models of therapeutic action in analysis. In Freud’s first model the focus was directed towards lifting repression. In later Freud and in Klein the emphasis shifts to the analysis of the internal world as lived in the transference. In Bion’s model the interplay between transference and counter transference is more to the fore. Here we see an important process of development regarding how the unconscious processes of the mind may be discerned and grasped. Freud originally saw the transference as a resistance to the analysis. Later he understood it as the main tool of psychoanalysis. A similar change occurred in relation to counter transference. Freud considered counter transference phenomena only as an expression of the analyst’s pathology. Understanding the power and concreteness of projective identifications, later generations realised that counter transference gives us invaluable information about the patient’s unconscious and we have to watch the interplay between the patient’s projections and our own reactions. We extended Heisenberg’s Principle of Uncertainty and the role of the observer. It is not only that the presence of the observer alters the field but the impact of the field alters the observer’s mind. I chose to present in more detail the Freud/Klein/Bion model because in all my experience I found it is the most useful. However, it should be emphasised that implicit in my notion of usefulness is awareness of the analytic aim and method of discerning ‘truth’.These three models are, in my view, most clearly directed towards this aim and method. I think that they are always at the back of my mind making me more perceptive to different kinds and levels of unconscious processes that exist in the mind. They promote awareness to unexpected beta elements as well as an ability to see them more openly in the psychotic, and as the patient progresses I can find myself functioning on a level much nearer to that described by Freud and open to the kinds of truth about unconscious processes that he describes. When I speak of the Freud/Klein/Bion model I must add that I do not include in that Bion’s later work84 on transformations in O and 84 Bion, W.R. 1997.

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becoming O, which has to do with a kind of immediate union with what Bion refers to as the ‘thing-in-itself ’. This seems to me very mystical – a sudden illumination coming from some unnameable O. It sounds too much like a transcendental Truth and therefore on two accounts is incongruent with the Freud/Klein/Bion model which I hold to: It stands opposed both to the scientific perspective of psychoanalysis which I have been describing which relies on knowledge gained through the gradual accumulation of clinical evidence, and to the fundamental aim of psychoanalysis to bring about change through gradually coming to know and withstand truth. Rather than speak of truth in terms of ‘illumination’ I prefer to use as guidance something Bion, Rosenfeld and I85 formulated: That psychoanalysis shares the worldview of science which has as its aim to see life ‘as it is’, and that what is peculiar to psychoanalysis is that in its scientific endeavour, in its steady pursuit of truth, it is in itself restorative. I have stressed at the beginning that any re-examination or overthrowing or change of the model requires validation and that mental sciences, like physical science, require constant evaluation. In the mental sciences this task is harder because the ‘facts’ that are discovered are immaterial facts. They can be observed but cannot be weighed or measured. I think our evaluation and testing ground is clinical experience.When I speak of clinical experience in this case I mean not only the actual work in the consulting room, which is basic, but also the wide experience of supervision, seminars, group work and, in particular, contact and interchange with people working with other models in which experiences can be examined and compared. Through such encounters we can validate or reject our hypotheses regarding the functioning of the mind.And through such encounters we can also further elucidate the basic aims and methods of psychoanalysis and come to grips with the special nature of its hypotheses and their therapeutic value – which distinguishes psychoanalysis from other valid fields of scientific inquiry. To come back to the terms of ‘truth’ and ‘tradition’, what I have been suggesting here is that we should always keep an open mind about our models and be willing to expand and modify them in the light of new evidence, new facts. If we fail to do so we submit to the 85 Segal, H. 1961.

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tyranny of the past rather than serve truth. But at the same time this openness will always be limited to some extent and rightly so. In part this is because new truths, new facts, will have to be considered against the background of our existing models, the knowledge that has already been accumulated and formulated in the available paradigms.These should be replaced only after a serious and careful process of examination and validation. A rebellious attitude towards our models – anything new is better – is also tyranny of the past. Here we see the contribution of tradition to the gradual development of psychoanalytic thinking.Tradition also sets limits in that it defines the object of our study and the nature of the change that we aim towards in psychoanalysis.As I have stressed, psychoanalysis is concerned with the mind, but specifically with the unconscious facets of the mind and the discovery of the truth about them; it is concerned with change, but specifically with change that occurs through truth and the development of the capacity to withstand it. Our openness to new truths, new facts will be guided by their contribution to these concerns, to this search for truth, which lies at the heart of the psychoanalytic tradition. In my own experience and evaluation I see no need to reject the basic parameters of setting and the psychoanalytic interaction in the transference derived from the clinical model of Freud/ Klein/Bion for, in my opinion, it is the one that leads us further towards the truth that psychoanalysis strives for.

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PA R T T W O

Contr ibutions to symposia, conferences and other occasional wr itings

Part Two of the book contains Segal’s presentations to symposia, conferences and other occasional writings from 1969 to 2000. It is the first time that such occasional writings have been included in a publication of Segal’s work. The material has been divided into six sections: models of the mind and mental processes, psychoanalytic technique, Segal on Klein, Segal on Bion, envy and narcissism and interviews.

Models of the mind and mental processes

Segal has developed her work on models of the mind over several years. She describes and relates to one another the models of the mind of Freud, Klein and Bion. In the process of doing this she also gives a clear view of the paradigm of mental functioning she has developed and used in her own clinical work.The most complete presentation of her view on models of the mind is to be found in the first piece in this section,‘Psychic structure and psychic change’ (1997). The next piece in this section, ‘The mind as conflict and compromise formation: comments on Charles Brenner’s paper’ (1992) has been included to enable comparison between a Kleinian and an American ego psychology perspective. In part, Segal agrees with Brenner’s statement that the concept of the id is redundant. She suggests that if needs, instincts, desires and wishes are split off into an agency like the id it is easy to disown them and it is more appropriate to see them as belonging to the ego. Segal does not agree that the concept of the superego is redundant. She does contend that it is inaccurate to perceive the superego as one internal object. A notable difference between their models of the mind is the absence in Brenner’s model of Freud’s concept of the life and death instincts, so central to Segal’s thinking about the mind. The third entry in this section is Segal’s 1992 paper ‘Acting on phantasy and acting on desire’. Segal’s ‘feel’ for border regions – those places in psychic life where different phenomena come into contact – is evident here in her thinking about the relationship between phantasy and reality. The paper gives a particularly clear 81

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account of Segal’s work on Freud’s ‘Two principles of mental functioning’. She proposes a somewhat new understanding of both principles. Segal contends that getting to know reality involves bringing a phantasy to bear on it and establishing the extent to which it is confirmed or contradicted, as a scientist does with a hypothesis. By contrast in her view the pleasure principle depends on an omnipotent phantasy and the individual is compelled to destroy any reality which threatens the phantasy. The following three entries in this section, ‘Symbolic equation and symbols’ (1996), ‘What is an object? The role of perception’ (1990), and ‘Projective identification: comments on Ruth Reisenberg Malcolm’s paper’ (1995) present key concepts in the Kleinian model of how the mind comes into being, how it develops and how psychic change is possible. It is through the process of symbolisation, succinctly described in the first entry, that a person becomes able to think. The concept of an internal object and the processes of projection and introjection are the subject of the remaining two entries. In her comments on projection, Segal emphasises the importance of voyeurism (projective identification through the eyes).This is the theme developed in her paper, ‘Vision’ (2004) in Part One of this book.The final piece in this section,‘The end of psychoanalysis?’ (1996) addresses the scientific status of the psychoanalytic study of the mind.

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7 Psychic str ucture and psychic change – chang ing models of the mind

Hanna Segal has developed her work on this subject over several years.86 We chose her presentation from the 1997 University College London Conference on Psychic Structure and Psychic Change as the best representation of her views. Segal has added a postscript to elaborate the central points further.

Almost from the beginning, when formulating a theory of mind, Freud saw the mind as having a structure. I think it is not often appreciated or emphasised how revolutionary that way of looking at the mind was. Until Freud, the mind was a rather vague concept. Seeing it as a structure implied that the psychic world, like the physical world, can be studied in terms of elements, or parts, combining into a structure. This can become a subject of detailed study of the different parts and their interactions. I said that the various elements, or parts, combine to form a structure, because it is an important aspect of Freud’s theory that structures are also seen by him in dynamic terms.They are the result of dynamic conflicting forces: not only forces in the past, defining a structure once and for all; he also saw it as something happening in the present, that is, that the same forces which are responsible for setting up the structure continue to maintain it.The implication of

86 These include her spoken contribution to the Joseph Sandler memorial meeting, March 1999 and her chapter ‘Changing models of the mind’ in Kleinian Theory: A Contemporary Perspective, ed. C. Bronstein, Whurr Publishers, 2001.

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this is that if the interplay of those forces changes, there is the possibility of a change in the structure, and this of course is essential from the point of view of therapeutic possibilities. One of the earliest of Freud’s statements about the therapeutic aims was ‘where id was there ego shall be’.87 This is at least a quantitative, if not a qualitative, change in the structure. Freud’s first model of the mind, known as the topographical model,88 is also structural, since it describes the structure of the mind in three layers – conscious, preconscious and unconscious. And it is also dynamic. It is the forces of repression that keep the id unconscious. The preconscious Freud originally thought of as containing those elements which are not at the moment conscious, but are readily available to consciousness. However, later, he included the concept of a censor between the preconscious and conscious where there was a conflict, and the dynamic elements in maintaining or releasing the censorship. But what is known as the structural theory of mind,89 though not contradicting and excluding the topographical description, introduces new and more important elements. It is the structural theory on which most modern psychoanalysis is based. The new element introduced into the structure is the essential role of an internal objectrelationship.There is the ego and the id, as in the previous model; but a crucial role is played by an internal object – the superego. And in this new model Freud introduces the idea of an internal object as an important structure in the ego. Concurrently and inevitably, the mechanism of introjection becomes central: an internal object is a parental (in Freud’s original view, paternal) object that has been actively introjected. But this introjected object is one that is also filled with projections. You must all remember Freud’s diagram of the pyramid, the basis of which is the id, but the superego is filled with the id. Freud originally explained it in complex ways to do with cathexes and decathexes; but in some later papers he speaks of projections into the superego.And Freud’s earlier formula,‘Where id was there ego shall be’90 could also be re-formulated as ‘Where superego 87 88 89 90

Freud, S. 1920. Freud, S. 1900, Chapter 7. Freud, S. 1923. Freud, S. 1920.

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was, there ego shall be’.The severity of the superego is an important therapeutic concern. Klein’s work extends Freud’s model. It is not that the superego disappears from her formulation. But it is, as it were, put under the microscope for she investigated the forces which shape it. Though Klein took as her basis Freud’s theory of instincts, and particularly the conflict between the life and death instincts, I think she refers less and less frequently to the concept of the id as a separate part of the personality. If she were here she might not agree with me; but my own view of the Kleinian model does not actually include the id as a structure. I view it more as the ego, being the I, which has perceptions, instincts and desires, expressed in object relationships. The structure of the self or the ego is determined by the way it organises its object relationships, which the ego in phantasy internalises and makes part of itself. Freud has said that the ego is a precipitate of abandoned objectcathexes.91 This formulation came before he described the superego, a concept which he introduced later. One could assume that this precipitate is the superego. However, I think that there are two aspects of that precipitate: some introjections are maintained as separate objects, with which the ego has a relationship – the superego described by Freud;92 other aspects of the introject the ego can identify with and, if ego-syntonic, they may contribute to this growth. (I use the term ego-syntonic in a particular way meaning specifically in the sense of contributing to the growth of the ego.) Of course Klein provides her own model of the structure93 with which you are familiar. She describes two different potential structures of the ego and its internal objects: one is what she calls the paranoid-schizoid position, in which the object is split between an ideal and a persecutory one: the roots of the ego-ideal and the persecutory superego. It is filled with projections, and often fragmented. Parallel with this – and Klein paid particular attention to the state of the ego (though hers is not called Ego Psychology) – the ego is split between what is held to be its good and its bad parts, and also frequently fragmented.

91 Freud, S. 1923. 92 Freud, S. 1923. 93 Klein, M. 1946.

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Klein saw how mental structure evolves through the withdrawal of projections, lessening of fragmentation, lessening of splits and the consequent restructuring of the ego and its objects from split to whole. In other words, the evolution to what she calls the depressive position.94 This in itself does not conflict with Freud’s id-egosuperego model. Nevertheless, there is a shift in emphasis to the importance of object relationships. It is the way the ego organises its internal objects which determines the structure. But there is a complication in this model, in the sense that the evolution is never completed, and in fact both structures co-exist, and there is a fluctuation between them. Is it then that the mind has two structures? Or is it that the one evolves into the other? In a way both statements are true.There is an evolution which is never completed, and the paramount question in relation to mental life is this: which one is the central core of the personality? And if the structure is the more mature structure of the depressive position, how much is this central core under threat from the paranoid-schizoid position? I think Bion’s work is helpful in further elucidating this problem. He proposes a different view of the model. In fact, in some of his writings he speaks of a new metapsychology.95 His model has as its central position the relationship between the container and the contained.To put this at its simplest, since you are probably all familiar with it, he extends Klein’s concept of projective identification into a model in which the infant projects what Bion calls beta elements, which are unorganised, inchoate elements of experience, into the maternal breast, where they undergo a transformation into alpha elements, which are elements of feeling, phantasy, and eventually thinking. When this container-contained conjunction is internalised, it becomes part of what Bion calls the mental apparatus. But one could see it also as a basic structuring of the ego.And he makes it clear that the formation of this apparatus is co-existent with the shift from paranoid-schizoid to depressive functioning. Melanie Klein, among other things, contended that in the shift between the paranoid-schizoid and depressive positions, repression takes over from splitting as the leading mechanism of

94 Klein, M. 1934 and 1940. 95 Bion, W.R. 1962a.

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defence. A reorganisation of the structure, and a splitting of the ego into different parts, gives way to a division between the conscious and unconscious ego. Bion amplifies that statement and looks from another angle at what is meant by repression. He looks on repression as a contact barrier not a dividing line – as a part of the mind in which there is a constant on-going transformation between the beta and alpha elements.96 In that part, processes of symbolisation happen which allow primitive contents to be transformed and used by the ego, allowing the person continuous contact with his or her unconscious in a way necessary to be in contact with external reality as well. Freud’s term was a permeable barrier.This amplifies the idea about repression I formulated in my work on symbolism, when I suggested that what Freud called an ‘excessive repression’97 was in fact a splitting-off of insufficiently symbolised material, whereas more normal repression gives rise to symbolisation and further elaboration. One could view the contact barrier described by Bion as a constant transformation in Freud’s terminology, of the id into the ego, in Klein’s formulation, from the paranoid-schizoid to depressive functioning and in his own terminology, from beta to alpha. Bion98 also emphasises that the contact barrier can be seen both as a function and as a structure in the mind. I think the structure he describes would be compatible with Freud’s topographical model. Bion’s model, however, is much more fluid than Freud’s topographical description because the beta-into-alpha transformation, and all the further developments, do not happen once and for all. Rather, there is a constant on-going transformation which is always active. But where this process fails, beta elements form a beta barrier, which precludes further transformation. This evolution, however, involves psychic pain at all its points: separateness, depressive guilt, oedipal pain; so at any stage this process can be impeded. And when it is impeded, pathological structures are formed. These pathological organisations, as described by John Steiner,99 preclude further development and could be seen as fixation 96 97 98 99

Bion, W.R. 1962b. Freud, S. 1915a. Bion, W.R. 1962b. Steiner, J. 1987.

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points.And this has important technical implications. I think we direct our attention primarily to the point at which pathological structures are formed. I have been trying to give a quick overview of the various structural concepts of the mind, of the way they have evolved and how they are, to a large degree, consistent with one another. I am well aware that there are other views of the structure: for instance, the Kohutian is quite different from the other views and to my mind less consistent with Freud’s structure. I have confined myself to summarising some of my own thoughts about models I am familiar with, all of which I find useful and have at the back of my mind during clinical work. The title of this paper is ‘Psychic structure and psychic change – changing models of the mind’.Therefore I have to address myself to the question of what happens in psychoanalysis. Does the structure of the mind alter? We make the claim that psychoanalysis differs from other therapies in that it leads to a structural change. This is not a universally held view. For instance, some analysts contend that the structure does not change; the nature of the internal objects does not change; but what does change is the attitude to the objects. It is true that our attitudes change, but how and why? I think a fundamental factor is the withdrawal of projections – the ego regains its lost parts and the object in phantasy is altered – this constitutes the change of attitude. On the other hand, anarchic structures never wholly disappear. I think we come here to the quantitative changes.Which phantasy predominates? What is the central structure, as it were; and what is split-off? If a shattered object,100 and with it a shattered ego, is at the centre of the personality structure, we can speak of structural change if through analytic work we can restore a more whole object and a more whole ego (with an ambivalence to such an object). If you have a ruined house with the bricks spread all over the place, and you manage to collect these stones or bricks and reconstruct the house, then though it is the same house and the same bricks I think we can well speak of structural change, even though we are well aware that there are still dynamic forces that might shatter it again.

100 This is a reference to Miss Daniel’s paper, ‘A shattered object’ given at the conference.

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I think there is an assumption in our work which may be optimistic. The assumption is that at the beginning of our life, a primitive ego is endowed with the capacity for perception of outer and inner realities and needs.We think that there is an inborn drive to integration. Freud describes the life instinct as aiming at combining, organising and integrating elements.Those inner capacities and drives of the ego may be severely impeded through external and internal factors, leading to pathological organisations and structures which impede growth and integration. But if we undertake a psychoanalysis we must act on the assumption that at least a vestige of these inner capacities and drives of the ego remain. However shattered the mental structure, or however empty it seems, as in the False Self, we believe that there is in some corner someone who is still at home. Mrs Klein’s Dick,101 the first autistic child to be analysed, was not playing, not speaking, not relating. But he still had a little interest in door-handles and trains – slight evidence that there was someone there who could be addressed. One could say that the little door-handle he was interested in could be used to open the door to his unconscious. If there is no one at home, for example, when severe organic damage has brought about a complete destruction of the primitive ego, then psychoanalysis is not possible, nor is any mental life. But where there is mental life, however damaged, then there is still someone at home and psychoanalysis may yet prove a therapeutic instrument.

Postscript 2005 I consider that being aware of the changing models of the mind in the course of our work is of great importance.There is no such thing as pure observation. All scientists approach the area of their research having in their mind, more or less consciously, a paradigm. This paradigm derives from previous experience and knowledge and must be open to correction by new experience and knowledge or it becomes a dogma. In mental sciences this paradigm is the model of the structure and function of the mind. In psychoanalysis we do not approach patients with an empty mind; we have a model of the mind in our own mind. 101 Klein, M. 1930.

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Case material The basic model is best illustrated by Freud’s sketch of the pyramid. It is both structural and dynamic. A patient, who was a naval officer, and had no previous knowledge of psychoanalysis, dreamt of a pyramid. At the bottom of this pyramid there was a group of rough sailors bearing a gold book on their heads. On this book stood a naval officer of the same rank as himself, and on his shoulders stood an admiral. The admiral, the patient said, seemed in his own way to exercise as great a pressure from above, and to be as awe-inspiring as the group of sailors who formed the base of the pyramid and pressed from below. Having told me this dream, he said, ‘This is myself. This is my world. The gold book represents a golden mean, a road on which I tried to keep. I am squashed between the pressure of my instincts and what I want to do, and the prohibitions coming to me from my conscience.’ He had some associations to his current situation, where as a second officer he had to negotiate between the captain of the ship and a rather unruly crew. This basic model has not been surpassed, but is encompassed in later developments evolving into what we could call the Freud/Klein model. For instance, as my patient’s analysis developed a hitherto split off area became accessible. This area contained most painful relationships, particularly to his sister who died in adolescence and his mother’s depression. His model of his mind changed and became more like the Freud/Klein model.

Bion expanded this model further by bringing in the differentiation between beta elements and alpha elements. One could say that Freud’s model is macroscopic, the Klein model is microscopic and the Bion model sub-atomic, looking for the basic elements that go into the composition of the microscopic and macroscopic. He introduces two lines of development active from the beginning: beta elements leading to concretisation, the beta barrier and psychosis and beta elements transformed into alpha elements leading to symbolisation, flexible repression and further development. The major battle between the two is in the depressive position, but the nature of the depressive position is influenced by previous developments.This model adds not only depth and precision but certain fluidity and emphasises the constant transformation in the human mind from the most primitive elements to the pre-conscious and the conscious. 90

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I would like to add another dimension and that is that the beta elements leading to concretisation, the beta barrier and psychosis are fuelled by the death instinct whilst beta elements transformed into alpha elements are fuelled by the life instinct, seeking growth and development. Beta elements are transformed into alpha elements by mother’s alpha function.That function is mobilised by mother’s love but it is not only environmental. For the infant to be able to internalise it in a constructive way, mother’s alpha functioning mobilises the infant’s own love of life and therefore of the life-giving object. Speaking of my own experience I think that being aware of the changing models of the mind makes me more able to spot clusters of beta elements and the defences against them. Such awareness also means that I am less taken unawares and dismayed by sudden eruptions of nearly pure beta elements as I describe in my papers ‘Interpretation of dreams – 100 years on’ and ‘Disillusionment:The story of Adam and Eve and that of Lucifer’.

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8 The mind as conflict and compromise for mation: comments on Charles Brenner’s paper

Segal was to be the discussant of Charles Brenner’s102 paper ‘The mind as conflict and compromise formation’ at the International Psychoanalytic Association Congress in San Francisco in 1995. She was unable to attend and sent a written comment. In his paper Brenner contends that Freud’s structural model should now be relinquished. In particular he states that there is no part of the mind which is mature, integrated and free of conflict, as he believes the structural theory takes to be the case with the ego. In the model proposed by Brenner, id, ego and superego are replaced by a ‘person’ all of whose mental functioning is regulated by the pleasureunpleasure principle. Instead of being in a ‘special category’ the superego becomes ‘one of the calamities of childhood, the calamity of parental disapproval’.

I very much regret that I am unable to be in San Francisco, and therefore shall not have the opportunity to take part in the discussion of Charles Brenner’s103 interesting and stimulating paper. Nevertheless, encouraged by the organisers of the Symposium, I am sending to you my short position paper, both because I wish to

102 Charles Brenner is an American psychoanalyst and author of a many publications including An Elementary Textbook of Psychoanalysis (1955); Psychoanalytic Concepts and the Structural Theory (1964) with J. Arlow; Psychoanalytic Technique and Psychic Conflict (1976); and The Mind in Conflict (1982). 103 Brenner, C. 1994.

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present a certain point of view and because I hope that it may contribute something to your discussions. In answer to the question whether I agree with Charles’s views as presented in this paper, my answer is that I have large areas of agreement and of disagreement with him.To begin with, I am in complete agreement with his view that Freud’s structural theory of mind104 was a very major development in psychoanalytical theory. From my point of view, the structural theory is a great step forward, because it defines the major conflict within the ego: ambivalence. It is contemporaneous, and related to, Freud’s last theory of instincts,105 in which he treats as central the conflict between the life and death drives, and its accompanying anxieties, and the defences mobilised by them. Secondly, it emphasises the importance of an internal object, the superego, and the importance of its being a phantasy object rather than a straight introjection of a real external figure. It is an internal object set up in the inner world as a result of ambivalence. I have a large area of agreement with Charles Brenner’s view that the concept of the id is redundant.A lot hinges on Freud’s description of the ego. Freud attributes to the ego many and varied functions: it is first of all a bodily ego; yet it is an organ of perception, not only of external realities but also inner realities. It is the seat of anxiety, an agency that produces defences, and, in Freud’s view, presides over the conflicts between the id and reality. But what Freud does not attribute to the ego is needs, instincts, desires, and wishes. All that is separated off as the id. I think making a separate agency of one’s instincts and unconscious phantasies is a way of disowning it. It is not me: it is it. I agree with Charles Brenner’s view that the ego, or whatever you call it, is an I, a Me. I would say that the ego is the I, the infant him/herself, at birth. It does not evolve from the id. It is an I, with conflicting desires and perceptions, the perceptions being, to begin with, distorted by desires; and when perceptions are distorted by desires they become delusions.And this I is naturally an immature ‘I’, which develops gradually. And my disagreement with Charles Brenner is about that aspect of the structural theory which has to do

104 Freud, S. 1923. 105 Freud, S. 1920.

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with the superego, because this matures physiologically, but it also develops psychically and that development happens in the interaction with an object or later object. Klein’s view was that there is more ego at birth than Freud assumed. If Charles Brenner’s view, and mine, is correct – that the ego is the infant – then of course it is present from birth, at least.And in Klein’s view, that ego or infant has from the beginning a need and a capacity to form object-relationships, in phantasy and reality.And its evolution is linked with the evolution of its relationship to the reality of objects. The infant, this immature ego, has to cope with life, with its own wish to live or abolish life, and with its experience of the objects, on which it depends and with which it has to contend.Those objects, through a series of projections and introjections, set up an internal phantasy world of internal objects, sometimes remaining separate and sometimes identified with. (Freud also described the ego as a precipitate of abandoned object-cathexes.) I seldom speak of the self, since there are so many different views of what the self is, but the way I see it is that the self is the ego-plusthe-internal-objects, which become structuralised in the mind. In the original primitive state, omnipotence rules and splitting leads to idealised and persecutory objects which are the primitive roots of the superego.The structure evolves as we gain a more mature perception in which we recognise our own ambivalence, withdraw our projections into the objects, and increasingly differentiate between feelings, phantasies and external perceptions.We also internalise more realistically perceived objects and develop more awareness of our own feelings – a change in structure which Klein called the shift from the paranoid-schizoid to the depressive position. I agree with Charles Brenner that conflicts do not disappear. Ambivalence is always with us in our interaction with an object or objects. It is crucial that ambivalence should be recognised and acknowledged, or we live in a delusional world. I also agree with Charles Brenner that one cannot attribute all feelings of guilt to the superego. The feelings of guilt arising out of the superego have a persecutory pressure due to our projections of aggression into the internal objects. But if the ego is an organ of perception of psychic and external realities, then it is capable of perceiving the damage done in reality, or in phantasy, and that perception is realistic guilt, a guilt which is proportional to intentions and appropriate to the damage 94

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done. Freud106 said,‘Where id was, there ego shall be’. I would rather say,‘Where superego was, there ego shall be’. The last point I wish to make has to do with the ego having the attributes of thinking, judging etc. I agree with Charles Brenner that these faculties develop gradually, but I do not think of this in terms the development of the human race; I think of them as they evolve individually in each individual’s maturation, as ways of dealing with object-relationships, particularly with the absence of a needed and desired object.Wilfred Bion107 said,‘No breast; therefore a thought’. In conclusion, I agree with Charles Brenner that the structural theory needs revising, but I would revise it in the following two ways: 1 The concept of the id is redundant; the I – the ego – has instincts and desires. 2 On the other hand, the role of the superego in mental structure is not redundant, but should be revised and enlarged. Our mental structure does not contain one object, internalised at one moment of development: the heir of the Oedipus complex.There is a whole internal phantasy world of object relationships which get structuralised within the ego. But this structure is not static: it develops and changes as part-and-parcel of the development of the ego.

106 Freud, S. 1923. 107 Bion, W.R. 1962a.

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9 Acting on phantasy and acting on desire

Hanna Segal first met the philosopher Richard Wollheim in the 1950s when she was invited to join the Imago Group. This was a small group of artists and intellectuals started by Ernest Jones and organised by Richard Wollheim and Adrian Stokes to discuss psychoanalysis and art. Segal and Wollheim remained in contact and exchanged ideas. This paper108 was written for Wollheim’s Festschrift109 in 1992.

I consider it an honour to contribute to a Festschrift for Richard Wollheim.Wollheim is unique among philosophers in his profound knowledge and understanding of psychoanalysis, which includes the more recent developments. He uses such psychoanalytical concepts as he finds useful to illuminate the broad borderline area of equal interest to psychoanalysts and philosophers, such as theories of knowledge, ethics, and aesthetics. In The Thread of Life110 he addresses himself to the subject of the philosophy of life itself, which was the great preoccupation of philosophy in the past, and which I think is sadly neglected by modern philosophy.This, of course, is a layman’s complaint. I have some apprehension about my contribution to this volume, since my knowledge of philosophy is only amateurish and superficial. What I can contribute springs from my own psychoanalytic 108 Segal, H. 1992. 109 A celebratory publication, usually a collection of writings published in honour of somebody recently deceased. Derived from 19th-century German, literally ‘festival writings’.

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experience, which enables me to address myself to some of the psychoanalytical concepts which underlie much of Wollheim’s work. The concept of unconscious phantasy is central in psychoanalysis, and Wollheim uses this concept in his work on the philosophy of mind. In The Thread of Life, he shows how unconscious phantasy enshrining archaic object relationships can dominate our minds and become ‘the tyranny of the past’ and an obstacle to freedom of choice and to leading a meaningful life. I want to address myself to the distinction that Wollheim establishes between ‘acting on phantasy’ and ‘acting on desire’. Phantasy can be contrasted with action.Wollheim says that phantasy has a weak relation to action. For, ‘Unlike desire on the one hand and imagination on the other hand, phantasy is not characteristically motivational: it does not conjoin with belief so that an intention is formed’.111 However, phantasy often propels to action. Phantasies are acted out. And acting out a phantasy is different from acting on desire.Wollheim shows the practical usefulness of the distinction: for instance, in his paper ‘Crime, punishment, and “pale criminality”’.112 One could say that in this distinction he applies the distinction that Freud made in ‘Formulations on the two principles of mental functioning’113 between the pleasure-pain principle and the reality principle: In the psychology which is founded on psycho-analysis we have become accustomed to taking as our starting-point the unconscious mental processes, with the peculiarities of which we have become acquainted through analysis.We consider these to be the older, primary processes, the residues of a phase of development in which they were the only kind of mental process.The governing purpose obeyed by these primary processes is easy to recognize; it is described as the pleasure-unpleasure principle, or more shortly the pleasure principle. These processes strive towards gaining pleasure; psychical activity draws back from any event which might arouse unpleasure. (Here we have repression.) Our dreams at night and our waking tendency to tear ourselves away from distressing 110 111 112 113

Wollheim, R. 1984. Wollheim, R. 1984. Wollheim, R. 1993. Freud, S. 1911a, xii: 218–19.

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impressions are remnants of the dominance of this principle and proofs of its power. It was only the non-occurrence of the expected satisfaction, the disappointment experienced, that led to the abandonment of this attempt at satisfaction by means of hallucination. Instead of it, the psychical apparatus had to decide to form a conception of the real circumstances in the external world and to endeavour to make a real alteration in them. A new principle of mental functioning was thus introduced; what was presented in the mind was no longer what was agreeable but what was real, even if it happened to be disagreeable. This setting-up of the reality principle proved to be a momentous step. There is a common misconception that acting on the pleasure-pain principle is acting on uninhibited desire. For instance, there is a popular view that sexual crimes are due to lack of inhibition and control of sexual desires.This is very far from being an ascertainable psychological fact. In Freud’s description, the omnipotent mind of the infant, under the sway of the pleasure-pain principle, hallucinates the breast when hungry. The desire disappears, and it is replaced by a hallucination. Thus the need to act to satisfy a desire disappears. However in ‘Formulations on the two principles of mental functioning’114 Freud does not in fact use the concept of phantasy crucial to Wollheim’s distinction. Freud sees phantasy as a late phenomenon after the reality principle has been established: With the introduction of the reality principle one species of thought-activity was split off; it was kept free from reality-testing and remained subordinated to the pleasure principle alone. This activity is phantasying, which begins already in children’s play, and later, continued as daydreaming, abandons dependence on real objects. (p. 222)

114 Freud, S. 1911a.

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What, then, is the hallucinatory wish-fulfilment? Since Freud’s time, specifically since Klein115 and Susan Isaacs,116 the concept of unconscious phantasy has been extended, and I think Wollheim uses the concept of phantasy in this new way. Klein, and following her, others, went into far more clinical detail about those early processes. In the earliest stages of development, which Klein called the paranoidschizoid position, the infant is dominated by omnipotence.Whereas Freud thought that phantasy is a late product and did not connect the early hallucinatory wish-fulfilment with phantasy, Klein sees it as a manifestation of phantasy. Every impulse and desire inherently carries with it a phantasy of its own fulfilment. Also, in 1911, Freud did not take into consideration basic destructive and self-destructive impulses, only libidinal ones. It was only in Beyond the Pleasure Principle117 that he gave Thanatos (the death instinct), a role equal to that of Eros (the life instinct). Klein, whose work started in the 1920s, considered that the omnipotent phantasy is called up by destructive desires as well as by libidinal ones and that the omnipotently-produced hallucinatory world consists not only of libidinal objects, but also of objects destroyed and destructive. Hence the very young infant swings from states of bliss to states of extreme distress. She also described as one of the most primitive mechanisms that of projective identification. Under the sway of the pleasure-pain principle, the infant wants to get rid of anything from him- or herself that causes distress, such as hunger, anxiety, and anger; and achieves this by projecting parts of him- or herself outside and attributing them to an object. Drives are projected and externalised. Love and desire are represented by an ideal breast, which the infant wants to introject and possess. Bad feelings and pain-giving parts of the self are equally projected onto the outside, giving rise to damaged, bad and persecuting objects.The consequence of the operation of projective identification is a constant blurring of perceptions of reality, both external and internal.The phantasised object obliterates the perceived object, distorting external reality; but the internal reality of one’s own

115 Klein, M. 1952b. 116 Isaacs, S. 1948. 117 Freud, S. 1920.

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needs and desires is equally blurred, since it has become vested in an object.The knowledge of one’s desires disappears. Wollheim comments that phantasy conceals desire. Projective identification, I think, is the mechanism by which it is achieved. In my view, acting on phantasy is characterised by certain conjoint phenomena: • a misperception of external reality • a misperception of internal reality, for instance, the reality of one’s desire • a compulsion to act rather than a choice of action. I shall return later to the point of the compulsion to act. Because of the importance of the misperception, I shall call what Wollheim calls ‘acting on phantasy’ ‘acting on delusion’. I shall illustrate this by gross examples from known criminal cases to try to show some of the mental mechanisms at work. I take these particular examples because they display so clearly the psychopathology involved, and also to follow Wollheim in applying his ideas to the problem of criminal responsibility. Many years ago, two small children, a boy and girl, were found murdered in a wood; and the murderer was never found.Years later a man who was in prison on another charge was undergoing intensive psychoanalytic psychotherapy. He admitted to his psychotherapist that he had killed those children. He had taken them to the wood to play with them, because he thought they were lonely. He felt lonely too. He thought he would make them happy playing and he would be less lonely himself. However, as he kept them for a long time, they were not amused any more, and as it was getting dark, the little boy began to get frightened and started crying that he wanted to go home. The man took a stone and crushed his skull with it. He did not know why, and because the little girl was a witness, he had to kill her too. That man, as a very small child, had been evacuated during the war. In his foster home he was ill-treated, terrified and lonely. He was so miserable that at the age of three he consciously and deliberately tried to kill himself by drinking cleaning fluid and eating shoe-polish. In his analysis it became quickly apparent that the little boy was perceived by the man as though he was himself as a small child.When he became frightened, lonely, and started to cry, it was as intolerable 100

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to the man as was the memory of himself in the same state of mind as the little boy. His suicidal impulse at the age of three became the compulsive murder of the little boy seen as the child in himself who had to be killed. A psychoanalytical view would be that the man projected into the child a part of himself that was unbearably painful. In a more recent murder of this kind, Nielsen, a schizoid, depressed, inadequate homosexual was killing young men just like himself.This was so clear that many commentators with no deep psychoanalytic knowledge noticed that he was killing an image of himself again and again. Again and again. The repetition compulsion is unavoidable, because if the aim of the murderer’s action is to destroy bad internal objects, or parts of himself, then the idea that those internal objects or impulses will disappear after being placed outside is a delusion. Sometimes it is an unbearable phantasy of an internal object that has to be got rid of. Some murderers murder because they think they have murdered. The wish to murder becomes a phantasy of having murdered and containing a corpse.This they get rid of by externalising the corpse, by producing one outside. Such mechanisms can be shown sometimes to underlie neurotic behaviour in borderline cases.

Case material For instance, I had a borderline, obsessional patient who used to deal with hunger by defecating. The underlying unconscious phantasy was that the perception of hunger was a bad thing inside him that he could get rid of by defecating. He had many conscious rationalisations of this behaviour. He dealt similarly with mental pain. When his mother, to whom he was extremely attached, died, he experienced no mourning, but had numerous dreams about her. He would write them down in a notebook and forget all about them. This was a mental equivalent of defecation. He would evacuate his pain into the notebook and in that way get rid of it. The pain could be his own sensation – hunger, the psychic pain of mourning an object, or an object – the dead mother felt as dead faeces inside him that he could defecate into the notebook. The mental mechanisms involved here are not very different from the ones I assume to underlie the behaviour of the child-murderer and of Nielsen.

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Murders of prostitutes are common. A murderer of prostitutes, A.,118 claimed that he was driven to kill them because the voice of God commanded it. One could say that he saw in the prostitutes his sexual mother, but failed to recognise their reality as separate, different people and was deluded in his unconscious belief that they were his sexual mother. Such hatred of a sexual mother is also linked with a delusional picture of the mother herself. All her other characteristics are split off, and she is seen as nothing but a vehicle of obscene sexuality.We know from our clinical practice that in such a situation the child’s own sexuality is also projected into the mother. Therefore killing a prostitute would be killing both his sexual mother and his own projected sexuality. Freud has established that in cases of pathological jealousy, for instance, the patient projects into the woman his own homosexual wishes for intercourse with a man. It is his own hateful sexuality that the murderer attacks in his prostitute victim. And yet killing is also a guilty act, so that projection was not enough for A. to justify the killing. His wish to kill was projected on to a god who ordered him to do so. I have no psychoanalytical knowledge of A., but his actions are partly understandable to me through experience with some of my patients. I still remember a rather hairy moment in my practice as a young psychoanalyst when a schizophrenic patient told me, rather sadly, that he did not like killing, but that there was nothing he could do now; all his voices (he used to have eight of them) now combined into one voice to tell him that he must kill me because I was all bad. I knew what the stimulus was in this situation. He saw a man’s hat in the hall.The patient was quite unaware either of his sexual desires or of his sexual jealousy in relation to me. The perception of the real situation and of his own desire to kill were replaced by a hallucinatory voice telling him that he must kill me because I was bad. These, as I said, are very gross examples, but this kind of delusion underlies irrational behaviour of a neurotic type as well. For instance, often compulsions of cleaning, washing, and so on are based on an underlying delusion that the patient has infected the world with his poisonous faeces and that he has to clean the infection away. The

118 Clinical material with thanks to Dr Arthur Hyatt Williams who discussed this case with Segal.

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action has to be repeated, endlessly, since the unrecognised impulse to infect remains unacknowledged and therefore active. There are, of course, differences between criminal acts and symptoms in neurosis, two major ones being that in the neurotic and the borderline patient the delusion does not invade the whole personality but is encapsulated in a symptom.Also, the ambivalence is more in evidence.This is clear, for instance, in the Rat Man’s manipulations of the stone in the path of his beloved, which Wollheim analyses in detail in The Thread of Life.119 Often there is also more rationalisation of acting out. Criminals and psychotics often have rationalisations for their behaviour too, but neurotics are usually better at it. Rationalisation of essentially primitive psychotic processes is easily observed in group thinking – for instance, in the political process. In genocide and racism, in the name of racial purity, we wipe out the dirty and dangerous opponent – not very different from the compulsion to kill prostitutes.We also project our responsibility on to high authorities, like the schizophrenic patient who wished to kill me or A. projecting the responsibility into God’s voice. But in the group process these delusions are rationalised in a way which makes them appear realistic and sensible. Underlying irrational action are delusions. In the psychotic or psychopathic criminal, they dominate the personality; in the neurotic, they are split off and encapsulated in symptoms. In the group they lead sometimes to guiltless, mad, destructive courses of action. But if the pleasure-pain principle creates a hallucinatory world which omnipotently satisfies desires, why act as well? Wollheim states that phantasy has a weak link with action. Nevertheless, there is sometimes a strong urge to act out a phantasy, and paradoxically the need to act out is more compulsive than the need to act on the basis of desire.Wollheim raises the question why this should be so. One of the answers he gives is that phantasy aims at perpetuating itself, and acting out perpetuates it. There are other factors as well.After all, we all want our daydreams to be realised; but we might abandon them when they turn out to be unrealisable, or when we recognise that if realised they would lead to disaster. Reality always intrudes and an omnipotent phantasy is

119 Wollheim, R. 1984.

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interfered with, and in the individual who clings to his omnipotence there is a particular compulsion to act on the phantasy in order to maintain the omnipotent world and destroy any reality which threatens it. There is also a further element. If one’s desires are transformed into hallucinated objects, one’s thoughts and phantasies are then felt as internal objects that have got to be got rid of if they bring discomfort. And the way to get rid of them is by acting them out. If the wish to murder one’s parent becomes a phantasy of a concrete corpse inside oneself, that corpse, the murderer feels, can be got rid of by producing a corpse outside. Wollheim says that phantasy exerts a lure.120 It lures one into action. I think that an important element in this lure is projective identification.A person who gets rid of his desires by projecting them into an external or internal object feels enthralled by this object. His motivation is felt not to be in his own desires but in objects – either external or hallucinated internal objects – whose dictates he has to obey.What in the more normal person is a desire, in the person living on projective identification is the lure of the object. This kind of functioning leads also to an inbuilt repetition compulsion, because it is a delusion that producing a corpse outside will enable one to rid one’s mind of an unwanted part of oneself or a persecuting internal object. Impulses and associated phantasies cannot in fact be got rid of in that way. So acting out brings only temporary relief and the action has to be repeated again and again. There is a lure in the objects into which a part of the self is projected; there is a link that cannot be broken or denied if the object is felt to be possessed by a part of oneself and becomes it, because reciprocally the self is then tied and, as it were, pulled by the object in which a part of it is invested. So far, stimulated by Wollheim’s paper on ‘Pale criminality’, I have mostly given examples of the kind of projection that may lead to a murderous acting out, having to do with the predominant projection of destructiveness. But a similarly pathological lure can be felt when there is an omnipotent and almost total projection of the libidinal aspect of the self and an idealised object. This kind of lure can be

120 Wollheim, R. 1993.

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easily observed, for instance, in the syndrome called de Clèrambault’s. It is a nearly mono-symptomatic form of psychosis most often affecting adolescent girls.The girl forms a delusional idea that a man is in love with her and destroys herself pursuing him against all evidence of his lack of interest. She attempts to destroy his life and effectively destroys her own.This condition is tragically and beautifully documented in the diaries of Adele H., the daughter of Victor Hugo (books and a film, The Story of Adele H (1975) by François Truffaut, have been based on the diaries).The other historical case frequently referred to in the literature is male. He was a Guards officer with a delusion about Queen Victoria. Both ended their lives in mental hospitals as deteriorated schizophrenics. The psychoanalytic understanding is that such a person has projected into his or her object an early idealised internal object and also all their own libidinal self, so that they see in the object all the good in the world and without it feel empty and useless. In milder forms we can observe this condition in what is known as the erotic transference in psychoanalysis. The patient attributes to the analyst his or her own libidinal desires and is convinced that the analyst is in love with the patient, and also projects into the analyst all his or her own faculties, so that he or she feels enslaved by the analyst.Actually, in psychoanalysis this kind of transference seems to affect men and women alike. On the face of it, a projection of good things into the object seems less destructive than projection of destructiveness; but in fact it is equally destructive in that it destroys all perception of reality of the external object and all faculties in the patient himself. Many deteriorate into a psychosis. It is also destructive to the objects of their affection, since such people often keep pursuing their beloved, persecuting and disrupting their lives. In the group situation, similar mechanisms are at play in followers of a charismatic leader, with similarly destructive consequences. Thus the operation of omnipotent projective identification can explain the paradox that acting on phantasy is acting on the pleasurepain principle, yet is not acting on desire. This also throws light on the paradox that a hallucinatory omnipotent phantasy can both have a weak link with action and yet, on the contrary, also compel action. This is dramatically illustrated, and can be observed in catatonics, who may spend months in total immobility, with no action, yet 105

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suddenly be compelled to violent action which is completely incomprehensible to the observer. But what is ‘acting on desire’? And what is the ‘reality principle’? Freud says that the reality principle is the pleasure-pain principle tested in reality. How can it be tested? A principle cannot be tested. A hypothesis can be tested. I think that it is implicit in desire that it gives rise to a phantasy of its fulfilment. It is the phantasy that is like a hypothesis which is being tested. A phantasy is like a wishful hypothesis which is constantly matched with reality. If the phantasy is omnipotent, desire disappears, and phantasy becomes a delusion. But in the more normal infant there is a capacity to perceive a reality different from the phantasy.The phantasy is tested. In a footnote to the ‘Two principles of mental functioning’121 Freud says: It will be rightly objected that an organisation that was a slave to the pleasure principle and neglected the reality of the external world could not maintain itself alive for the shortest time, so that it could not have come into existence at all. The employment of a fiction like this is, however, justified when one considers that the infant – provided one includes with it the care it receives from its mother – does almost realise a psychical system of this kind. (p. 220, my italics) I emphasise ‘almost’ because an infant that obeyed only the pleasurepain principle could not survive, whatever the care of the mother. Were he satisfied with the hallucination, he would refuse the food and care of the mother, since the latter never comes up to the ideal expectation. The infant has to tolerate such discrepancies, and his capacities to recognise an object that is not identical with his phantasy and to relate to it, is the basis of his maturation. From the beginning of life, the infant is faced with the choice of testing his phantasy against reality – letting reality modulate his phantasy or attacking reality – that is, primarily attacking and destroying his own capacity for perception. The extent to which the infant can tolerate reality depends both on his inner capacities to tolerate frustration and on the degree of frustration or satisfaction provided by the environment. 121 Freud, S. 1911a.

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Forming a picture of the real object, differentiating it from the hallucinated object, and noting its real characteristics, good and bad, can lead to a search for the action to obtain the most satisfaction from the object.A rational action must be based on recognition of reality. Freud emphasises the importance of the recognition of an external reality.This, however, is inextricably linked with the recognition of the internal reality of one’s own desires and phantasies.This recognition necessitates toleration of gaps in satisfaction, and therefore of one’s own ambivalence towards the desired object. Again in ‘Two principles of mental functioning’,122 Freud speaks of two ways of dealing with this gap. One is the omnipotent hallucinatory phantasy; the other leads to the development of thought. He describes thought as ‘experimental action’. I think the original experimental action is the phantasy. Phantasies can be tested by perception; some by action: crying when hungry, biting in anger, attracting attention and love with a smile, and so forth. But there is also an experimental testing of the phantasy without an action. If phantasy is, as I suggest, a set of primitive hypotheses about the nature of the object and the world, one can experiment in phantasy with, ‘What would happen if . . .’. For instance, ‘What if I devoured my mother?’ or, ‘What if I annihilated my mother or my father?’ Such a ‘What if . . .?’ includes the realisation of the consequences of a possible action or its impossibility. It differs from the delusional phantasy which creates an ‘as-if ’ world, and it introduces a consideration of a ‘what-if?’, a consideration of probabilities of ‘what would happen if . . .’. It is the basis of imagination, as distinct from delusion, or daydreams based on a delusion, and is the basis of flexible thought and rational action, since rational action takes into consideration the consequences of the action. Rationality necessitates imagination. I have said that some capacity for this kind of functioning is present from the beginning of development; but it is achieved in small steps by the infant’s tolerating discrepancies between his desires and fears on the one hand, and reality on the other, and only very slowly does he emerge from his omnipotent world. The real battleground between the two modes of mental functioning described by Freud, happen in what Klein described as the depressive position, which she 122 Freud, S. 1911a.

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defined as the infant beginning to relate to the mother, and soon after to both parents, as real, whole objects. By ‘whole objects’ she means that they are seen as real and separate persons. The toleration of experience that the original part-object does not correspond to one’s phantasy initiates a withdrawal of projective identifications. As those projections are withdrawn, the object is perceived not as split into its bad and its good parts, but as being a whole which has many different characteristics. At the same time as the splits in the infant diminish, since he is less driven to project unwanted parts of himself and feelings, he feels more whole, and becomes aware of his ambivalence and inner conflicts between contradicting desires. This is a step towards recognising the real world as perceived and separated from one’s self and one’s own inner world. And it brings awareness of internal conflict. The awareness of the consequences of one’s phantasies becomes more acute: for instance,‘If I kill the mother I hate, I would lose the mother I love.’ ‘If I kill my father and destroy my siblings, I shall not regain my mother for myself but shall be landed with a depressed, empty, destroyed, and possibly vengeful, or endlessly possessive widow,’ and so on. And even if the child is aware that he cannot carry out such wishes in external reality, the phantasies are vivid enough to make a change in his internal reality and the kind of objects that inner world is peopled with. Bringing together his good and bad wishes creates guilt and fear of loss of good feelings and good objects in the inner world. Therefore such wishes and phantasies tend to be repressed. Freud speaks of repression in the passage quoted; he describes the pleasure-pain principle as,‘Psychical activity [which] draws back from any event that might arouse unpleasure. (Here we have repression.)’ (p. 219). At that time Freud saw repression as a general defence mechanism; later he discovered many others. Now we are inclined to think that in the primitive functioning of the pleasure-pain principle, repression plays no part.The state of omnipotently getting rid of pain is achieved by more primitive defences such as splitting, projection, and reintrojection. Repression, as we understand it today, begins to function where the ego is sufficiently aware of the differentiation between external and internal realities to deal with unwanted impulses by repression.Archaic desires, however, are never completely given up. When they are repressed, they find their satisfaction by 108

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symbolic expressions. One of Freud’s first discoveries was that repressed wishes express themselves symbolically. And symbolism undergoes a significant change in the depressive position. In the depressive position the phantasy of the object as possessed by projective identification is given up, and is replaced by an object representation in memory and desire which is retained, though it might be repressed. In his paper ‘Success and failure in mental maturation’,123 MoneyKyrle makes the point that in the depressive position there is an integration of various aspects of the original objects so that they become whole and complex, and our attitudes to them are equally complex; but that on the other hand a diversification occurs (MoneyKyrle calls it a ‘parallel version’).This is due to the ability to recognise various characteristics of the same original object and find various symbols for the various aspects; and finding appropriate symbols depends on the appreciation of the real qualities of the real object, which is used as a symbol.This leads to enlargement of symbolisation. I think these considerations may also be relevant to the distinction Wollheim makes between dispositional phantasies and occurrent phantasies.According to Wollheim, dispositional phantasies define our personality, character, and modes of behaviour, and are based on archaic introjections. Occurrent phantasies, on the other hand, are mental states; they are stirred by occurrent events. According to Wollheim, the occurrent phantasies may be more or less under the dominance of the dispositional ones. I think the extent to which the dispositional phantasy dominates the occurrent phantasy may depend on the nature of the dispositional phantasies. If the dispositional phantasies are based predominantly on omnipotent projective identification, the occurrent phantasies would be dominated by them.The event of meeting a prostitute in the case of the prostitute-murderer or a crying, little boy in the case of the child-murderer stirs occurrent phantasies which are totally dominated by the compulsion to act out basic dispositional phantasies. On the other hand, if the basic dispositional phantasies are of the more depressive kind, there is built into them flexibility and an adaptability for current situations to be recognised for what they are, 123 Money-Kyrle, R. 1965.

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so that the occurrent phantasies are more diverse and more appropriate to prevailing circumstances. In this paper I have tried to address myself to two useful concepts introduced by Wollheim: the distinction between acting on phantasy and acting on desire and that between occurrent and dispositional phantasies.These concepts stimulated me to further thoughts on the functioning of unconscious phantasy. I think his work provides an invaluable bridge between the philosophical and the psychoanalytical understanding of the phenomena of mental life, and exemplifies the cross-fertilisation possible between the work of philosophers and that of psychoanalysts.

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10 Symbolic equation and symbols 124

The concept of the symbolic equation appears for the first time in my first paper,‘Some aspects of the analysis of a schizophrenic’,125 in connection with the difficulty of symbolisation in my schizophrenic patient. The patient made no distinction between symbols and the objects they symbolised. For him, being like something and being something was the same. Symbols were equivalent to the things symbolised. There was an unconscious equation between the two. In my second paper,‘A psycho-analytic contribution to aesthetics’126 I describe symbol formation as a precipitate of mourning. In ‘Notes on symbol formation’127 I formulate a theory of the dynamics of symbol-formation and the role played by projective identification. Symbolism as tripartite relationship of Self, Object and Symbol.When projective identification is excessive, part of the ego becomes identified with the object, while the symbol, which is a creation and function of the ego, becomes identified with the object symbolised. In the depressive position, the object is given up and a symbolic representation of the object is formed in the ego in the process of mourning. The following differentiation can be made: 124 Segal, H. 2002, ‘Symbolic equation and symbols’, Dictionnaire International de la Psychanalyse. 125 Segal, H. 1950. 126 Segal, H. 1952. 127 Segal, H. 1957.

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Symbolic equations

Symbols

1.Arise in the paranoid-schizoid 1. Symbols are formed when position through projective projective identification is identification. withdrawn in the depressive position, and they are the precipitate of mourning. 2.The symbol’s own characteristics are not recognised.They are treated as though they were the original object.

2.The symbol is not felt to be the object, but represents the object. Its own characteristics are recognised and respected.

3.The symbolic equation is used 3.The symbol is used, not to to deny the loss of the object. deny, but to overcome the loss. 4. It is the basis of acting out and symptoms.

4. Symbolism is at the basis of sublimation and it governs communication both external and internal.

In normal repression there is a communication between the unconscious and the conscious through symbols. In the kind of repression which Freud called ‘excessive’,128 the unconscious is split off from the conscious, and in the return of the repressed, consciousness is invaded by concrete symbols, as in hallucinations. Under stress, there may be a regression from symbolic functioning to symbolic equation; for instance, in the schizophrenic patient described in the first paper.Thoughts and words, which were formed in the depressive position, became concretised, so that he could not, for instance, use names, because he experienced it as biting into the person named. Another example I give in ‘Depression in the schizophrenic’129 is of a girl who wrote a story about Lancashire

128 Freud, S. 1915a. 129 Segal, H. 1956.

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witches, and in a state of breakdown, felt herself to be persecuted by Lancashire witches. In my later papers, I follow Bion130 in accepting that it is not excessive projective identification which is responsible for the disturbance, but pathological projective identification. I made connections between my work on symbol-formation and Bion’s alpha- and beta-elements.131

130 Bion, W.R. 1957. 131 See the entries on alpha elements in this book (Chapters 23 and 24).

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11 What is an object? The role of perception 132

This paper was given to a European Psychoanalytic Federation Symposium in Vienna in March 1990 on ‘What is an object?’. Senior analysts from several European countries took part in the discussion.

What is an object? In ordinary speech an object is anything that has material existence in the world. It is usually inorganic and most often man-made. That of course is not what psychoanalysts mean by an object. Our use of ‘object’ is based on the grammatical distinction between a subject and an object.The object is what the subject relates to, whether in the accusative, the dative or ablative form. Almost in defiance of usual associations to the word object, the psychoanalyst’s object is human, and, to make matters worse, it can also be immaterial. Our internal objects are thoughts, not things. What does a psychoanalyst call an object? I think to us the object is something that is cathected by the subject. Originally Freud thought of an object as an object of instinct. I think that more commonly now we see the cathexis as not being purely instinctual.We see the infant as having emotional as well as biological or physical needs and the object as an object of the infant rather than an object of the infant’s instincts. I think an object in the psychoanalytic sense is someone, or something, that has for us an emotional meaning. It is needed, or

132 Segal, H. 1990b.

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loved, hated or feared. Of necessity it is an object of perception: you cannot relate to what you do not perceive. So the theme that you propose to us,‘What is an object?’ is enormous. It is almost the totality of our emotional experience. I shall therefore confine myself to one aspect of the topic only, and that is the role of perception in relation to external objects and to the creation of the internal ones. I shall start, boldly, by assuming that we have got inborn mental structures based on biological needs (and this in the human includes psychological needs as well), which become activated at various times of maturation. In my view those structures are related to phantasies of the self and its basic relation to primary objects. Freud had assumed inborn phantasies, such as castration phantasies, as arising out of our common prehistoric past. Klein and Isaacs related them to the operation of instincts. I follow Bion and Money-Kyrle in believing that we have inborn phantasies relating to basic biological functions, such as feeding and intercourse, providing a basis which Bion calls preconceptions and which become realised on meeting reality to become a concept. I would add that the concept is that of an object. What I am saying here parallels Chomsky’s view of the development of language. I am always struck by how near he is to a psychoanalytical viewpoint. For instance, he emphasises that language is not a habit or merely a skill to be taught and learned, but that it is always a creative act. He assumes, and indeed demonstrates, that there is an inborn grammatical structure which does not need to be learned. This inborn ability interacts with a vocabulary and grammatical form offered by the external world to create a language. Chomsky133 argues learning a language is a creative activity, with internal sources and parameters, and it is this aspect of his cognitive psychology which makes him such a formidable opponent of behaviourism. Having an inborn grammatical structure, and yet being able to acquire the different grammars of different languages are not contradictory. It is like our view that there is an inborn structure of an Oedipus complex but its actual realisations may be different in varying cultures.

133 Chomsky, N. 1957.

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Case material Patient A’s material illustrates my point. She started the session by telling me that she had two very tiny fragments of a dream. In one, she saw me surrounded by middle-aged, stupid, altogether despicable men. Of the second fragment she could remember only that it had something to do with African land and African people. The first dream seemed to both of us pretty obvious, with an impending long weekend. But the hardlyremembered-fragment dream brought surprisingly rich associations. To begin with, she expressed again her horror of racial prejudices she cannot free herself from, and which she detests in herself. That seemed to provide a link between the second dream of men I may spend my weekend with and the first about the Africans. But her other associations were more unexpected and illuminating. The patient is a form teacher and she started speaking about a child’s difficulty in learning any grammar, particularly foreign grammar. She thought Africa may represent what this girl feels about grammar as totally exotic and incomprehensible. This child, she said, is quite clever, but very disjointed. She seems unable to make certain connections, and this seems particularly obvious in her total inability to grasp the rules of grammar. After all, grammar with the sort of patterns it describes, should come more naturally. Then she laughed and said, ‘Maybe to her grammar is so foreign and exotic – just like parents in intercourse must appear to the child – beyond reach, incomprehensible, exotic, foreign.’ This patient is often preoccupied and disturbed by very primitive fantasies of the primal scene. In this session she seems to feel that there are certain natural patterns of interrelationships, as in grammar, and that this includes an intuitive awareness of parental intercourse. In the first dream that intercourse is attacked and derided. She has a prejudice against it, like a prejudice against Africans. And her associations to it suggest that she is aware how her thinking is dislocated by her attack on those natural patterns of relationships. She made an intuitive link between grammar and object relationships. She feels that there is a natural pattern in both.

When I say ‘parallel to Chomsky’ I do not wish to imply, as the Lacanians do, that the unconscious has the structure of language. But rather that both the object-relations structures as studied by us and the structure of language have the same sources in what Chomsky 116

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calls human functions. In fact, I consider that the development of language springs from object-relations and therefore has similarities to it, rather than the other way round. I think it is pretty universally accepted now that perception is not passive, not acting on a mind which is a tabula rasa; it is an active interaction between the mind and the external world. I have described earlier this interaction134 as largely an interaction between phantasy and perception. I suggested that the only thing that can be tested in reality-testing is an hypothesis and that primitive phantasies (which later Bion called preconceptions) are like hypotheses which are tested in perception. This matching of inner phantasies with realities I think exists from the beginning of life. Freud says, in a famous footnote to his paper on ‘The two principles of mental functioning’:135 It will rightly be objected that an object which was a slave to the pleasure principle and neglected the reality of the external world could not maintain itself alive for the shortest time, so that it could not have come into existence at all.The employment of a fiction like this is, however, justified when one considers that the infant – provided one includes with it the care it receives from its mother – does almost realize a psychical system of this kind. To me, in this footnote the operative world is ‘almost’, since an infant in the care of even the best mother, if he was totally under the domination of the pleasure-pain principle would not feed, since he would not know that he was hungry. Some anorexic babies bear this out, and in analysing adult anorexics one realises how they can annihilate the experience of hunger. However, the battle between perception of reality and the omnipotent imposition of phantasy onto reality is a long battle which proceeds in small steps. Part of this battle is a constant attack on perception by the omnipotent self, and it is not only an attack on external perception but also an attack on perception of one’s own inner states, and, as I assume, on the inborn phantasies such as parental intercourse, which interfere with one’s omnipotence, as shown by my patient. 134 Segal, H. 1981a. 135 Freud, S. 1911a.

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Money-Kyrle remarks that it is striking how children have every conceivable theory about the parental intercourse except the right one, and considers it an attack on what I would call phantasy and Bion would call the original preconception of such a happening. Similarly, the wish for narcissistic omnipotence can enviously attack the preconception of a feeding breast. Objects which are observed clinically are neither pure perception, in the case of external objects, nor pure primary phantasies, if internal: but the result of the interaction between the inborn patterns and experience. An infant under sway of omnipotent phantasies creates a world based on his projections, and one of the characteristics of this world is rigidity. The objects in the external world are perceived always in the same way, since they reflect and embody the subject’s own primitive phantasies and parts of his projected self.They are rigid and repetitive because they are not modulated by the interaction with reality.

Case material A repetitive dream of Patient B, who suffered from a gastric ulcer, illustrates that point. He has had a dream, close to a nightmare, on and off ever since he could remember. As a very small child he remembered waking up from his dream in a panic. In the dream he is completely tied to a chair in a half-lying position. From all sides he is threatened by some elongated animals with crocodile mouths. In the course of his analysis the dream first occurred in the context of castration fears of having his penis bitten off or chopped off as a punishment for masturbating. In the dream he is being tied to a chair to immobilise his hands. The dream appeared again in the context of a phantasy of me being pregnant and his attacking the inside of my body and the babies therein. The unformed elongated shapes with crocodile mouths represented the dangerous babies inside mother. The dream kept recurring in various contexts. In one session something struck me in his posture on the couch as he was telling me that the dream had recurred, and I asked him whether he had ever been swaddled as a baby. He said that he was, for four months, and also he was told he was always screaming with pain. It was diagnosed as colic. I thought that the elongated body and the enormous

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Models of the mind and mental processes dangerous mouth was his experience of himself at that time projected outside into his object and colouring his perception. Since that session the dream stopped recurring, and eventually the psychosomatic symptom disappeared as well. It seems to me that at the core of his personality this patient had a perception of an object endowed with his own characteristics as a swaddled infant, an immobilised body and a hungry, angry, enormous biting mouth. The perception of this object is deeply repressed and split off from the rest of his personality. At the most primitive level it is contained in the psychosomatic symptom. But it is also transferred onto other objects; women, children, men. They imbue the perception of those other objects with characteristics which are monotonously the same. He feels very persecuted by his wife, and has a phantasy of a vagina dentate. He perceives children as demanding and damaging and is persecuted by men, particularly in his professional life. There is a monotonous rigidity to his object-relationships because of the constant projection into them of this basic persecutory object. I shall bring a session from another rigid patient which shows a shift, at least temporarily and soon attacked again, in the direction of an internal object which includes a correction by reality. This patient swings between states of schizoid withdrawal and manic over-activity, very monotonously. Each of these states is accompanied by persecution which drives him into the other state. The patient is not overtly psychotic; on a superficial level he functions adequately in reality, but his human relations are superficial and unsatisfactory. He first went into analysis in late adolescence because of a fear of being schizophrenic. He came to me in middle-age because of a general dissatisfaction with himself and his life. In analysis we could discover basic object-relationships underlying these states. In the withdrawn state he was relating to a breast-womb inside which he resides and is free of destructive impulses. In his phantasies and associations following a dream about a pink room we discovered a phantasy of pink brothels. These were highly erotised phantasies, but actually girls hardly figured in them. He could withdraw into such states on the couch and feel blissful. In the manic state, in which he could be quite aggressive, he was identified with a phallus, or else he was idealising his own faeces, which could be seen as food, babies, or a powerful faecal penis. He originates from Scotland and idealises enormously

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Yesterday, today and tomorrow his land property there. For weeks and after a holiday he withdrew in his mind to Scotland. The session I report is a few weeks before a holiday on which he was proposing to go to Scotland. He started the session by telling me three dreams. For some time before the dream I shall present, the patient was concerned with his lapses of memory. He admitted something that I had noticed for a long time, but which he denied, namely that if I made a reference to a previous session or past situations he often had no memory of them at all. The same was true within the session. I could refer to what he had said five or ten minutes before, and he would realise that it was a complete blank in his mind. He would cover up by over-talking, which he now admitted was often quite a conscious device to hide his lapses from me. Connected with this over-talking was his tendency to dispose of my interpretations by vague associations, abstractions, and generalisations, stripping the experience of any emotional meaning, and often getting confused at the end. I sometimes had the experience that listening to him was like walking in a mist, unable to find one’s way. The first dream he told me he found very moving. You were in Scotland and I was thrilled to see you. It was marvellous having you there. But it was not like the last occasion you were in Scotland. I had nothing to do with it. I did not even know what your lecture was to be about. It was a strange experience because I was so pleased to see you, and yet I felt so excluded. It was so awful not even knowing what you planned, what was on your mind. (I had been in Scotland to lecture a couple of years before, during a holiday, so the patient, who was there as well, knew about it and came to my lecture. He was terribly pleased, but he experienced it as though he had arranged the whole thing and could exhibit me, his marvellous analyst, to the Scottish audience.) In the second dream the analyst disappears; he himself gives the lecture to a very big audience but he is given a theme that is much too vague and general, something like how to apply analysis to one’s work. He is dissatisfied with it. The lecture itself does not appear in the dream, but afterwards there is a social gathering. A girl, an ex-student of his, shows him a family watch which he had given her. It doesn’t work and he promises to fix it. The watch is very big: it is tubular and striped, transparent strips alternate with black, opaque ones. His first associations were to my previous trip to Scotland, and how different it was from the dream. Then he did not feel excluded; he felt

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Models of the mind and mental processes enlarged; the painful exclusion in the dream was much more like he often feels in England. But he found the dream very moving: it was so good to have me in Scotland, even though it was so painful. In the third dream he was trying to mend a crumbling wall. He thought he had the dream because of the relief he felt after the Friday session in which we discussed his lapses of memory. He thought that the transparent and black opaque stripes were like lapses of memory – ‘Now I remember; now I don’t’. (I also thought that the tubular watch, which was more like a clock, had some link with a tubular clock I used to have on my desk some years ago, which was black. But when I queried could it be a clock rather than a watch, it did not bring back the memory of my clock.) He also connected the watch with feeling very shocked when I ended the session on Friday. He usually withdraws and is prepared for the ending, but this time it took him quite unawares. The crumbling wall he associated to a neighbour who built a wall on a crumbling cliff and made a much too heavy superstructure on something that did not have a proper foundation. He said he had had a very good weekend in Scotland and that it was the effect of the Friday session. I kept an open mind. He always has a marvellous time in Scotland, and is invariably manic on holidays. We were a few weeks from the holiday. I wondered if the good weekend was because of the clear patches (in his head) or because of the black patches, having got rid of the memory of the experience. However, it was significant that he did think a lot about the Friday session, and in contrast to the usual lack of memory he could immediately connect the dream with it. I took up his associations and linked them also with generalisation and vagueness, which we had also discussed on Friday. I think the first dream represents a shift. I thought myself in Scotland over the weekend break was myself represented in his mind. He connected it with remembering the previous session and thinking about it. He is delighted, but if he wants to keep me in his mind as I really am he also has to admit the perception of me as a very separate object. He is not in control and not only is he not omnipotent, making me come to Scotland as he had felt on a previous occasion; he is also not omniscient: he does not know what is on my mind. Hence, when I am this kind of internal object, which includes his reality perceptions, it is a situation of both gratification and pain. The next dream is an attack on this perception. I disappear; he is me; he gives the lecture. In reality he often behaves and feels as though he were me. But the lecture has no substance. The people

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Yesterday, today and tomorrow in the audience are also not real perceived objects but projected parts of his child-self. The tubular watch (and in that too a memory of my tubular clock is obliterated) represents very well what he feels about his patchy memory. The too-heavy superstructure which collapses because it has no foundation is exactly what happens when he gives his empty lecture. Somewhere in the background the crumbling foundations represent the analyst destroyed in his memory. What I want to illustrate by this material is the shift in this perception of the object. The second and third dreams represent his more usual state of mind, with narcissistic object-relationships achieved by projective identification by which the true perception of the object is annihilated. The first dream represents a move to an internal object which is a combination of wishful phantasy: to have me in Scotland; also to have me as a part of himself in his mind; and a perception – an object experienced as having given gratification, hence desired but not omnipotently possessed. I want to emphasise that he does not know what is on my mind. I was always struck by the way some schizophrenics have a way of looking into your eyes and saying ‘I know what you are thinking’. Of course they do. They think they put those thoughts into your mind. Therefore the objects are perceived as being known right through. In the schizophrenic this is a core of conscious delusion; in the neurotic it is an unconscious phantasy but it colours perception of external objects, as in the other patient I quoted. And the objects are repetitive, always the same, since no new thoughts arise. In contrast, in that dream the patient does not know what is on my mind. One could say I am not a saturated object, therefore I am open to variation. If he re-projects such an object into the external world he could recognise what in the object does correspond to his internal phantasies, aspects of his primary objects or of himself – what is known to him – and yet recognise too that he does not know everything about his object. It is therefore open to exploration and allows him to differentiate between external objects and their minds, and his internal projected phantasy; and also to differentiate them from one another. In the reinternalisation he also acquires a variety of objects with different characteristics. The move is from rigidity to flexibility in the perception of external and internal objects. The nature of identifications also changes. In the following sessions the patient commented on the improvements in his memory. He also told me that in the past he did not bother to remember. He left it to me. It was my job; that is how analysis works. Now he began to feel that he too could,

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Models of the mind and mental processes and should, exercise this function. Instead of the empty, narcissistic identification with me, he selectively chose an introjection and identification with a basically necessary function.

In the course of development, normally the perception of objects undergoes an evolution in the direction of a lessening of distorted perceptions. One can see such an evolution in the process of the analysis, as well as in the factors interfering with it, which lead to a regression, as shown in the to-and-fro of patient C’s material.

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12 Projective identification: comments on Ruth Riesenberg Malcolm’s paper

The Riesenberg Malcolm paper discussed by Segal is ‘The mirror: a perverse sexual phantasy seen in a woman as a defence against psychotic breakdown’.136 Inside the mirror a number of sexual, cruel and humiliating activities take place between mostly incestuous couples. Outside the mirror (which has one-way vision) are onlookers whose excitement can cause them to be drawn into the mirror. Riesenberg Malcolm argues that the phantasy is an attempt by the patient to defend against, and reconstruct, an ego which is felt to be in bits, just like the destroyed parental intercourse that is contained by the patient. The paper presents the analytic work done in understanding the anxieties coming from the patient’s fragmented internal world and the consequent greater sense of integration in the patient. Segal’s comments were made at a conference on projective identification at University College London in 1995.

Mrs Klein,137 in discussing the depressive position, makes the strong point that it is part-and-parcel of the depressive position that projective identifications are gradually withdrawn, allowing for the more realistic perception of the mother as a whole object. She does not go into details as to how this is accomplished. She accounts for it partly by the infant’s growing capacity to perceive the object through time and to have a growing awareness of the real qualities of the

136 Riesenberg Malcolm, R. 1999. Ruth Riesenberg Malcolm is a British Kleinian psychoanalyst and author of On Bearing Unbearable States of Mind. 137 Klein, M. 1952b, Chapters 6 and 8.

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object. I think concern for the object also plays an important part, since projective identification attacks the integrity and identity of the object. In turn, the whole-object relationship militates towards the withdrawal of projections. Bion138 extended the understanding of this process by including the role of the containment and transformation by the object of the projected parts.This perspective on the process of projective identification is immediately relevant for technique, and to the understanding of the psychoanalytic process, because in the analytical situation the transformation has to happen in the mind of the analyst. Mrs Malcolm has described this process in two patients, X and B.

Case material In Patient X, she describes how the patient managed to provoke in her an undue feeling of curiosity about people and events in Patient X.’s mind, combined with a feeling of being left out of some exciting scene. She interpreted it to the patient as the patient’s identification with the primal scene, and the projection into the analyst of the feelings of left-out-ness and enormous curiosity. Following the patient’s acceptance of this insight (and I speak of the patient ‘accepting this insight’ rather than following this interpretation, because I have no doubt that this kind of material had been interpreted on other occasions) the patient brought to the analysis something withheld so far – the description of her compulsive masturbation fantasy. In this fantasy, some exciting sexual scenes are going on of an intense and perverse kind in a mirror, and there are observers who are irresistibly drawn into the mirror to become part of the scene: whereas some observers seem to resist the temptation, they note what goes on. The patient in the fantasy is both observing the scene and yet feeling that she is part of every feeling and action in the mirror. This is consistent with Mrs Malcolm’s feeling that the patient was identified with the primal scene, with the analyst’s curiosity over-stimulated and, as it were, pulling her into the scene. But I think there is more to it than that, which has to do with the nature of the curiosity. In the masturbation fantasy the patient is

138 Bion, W.R. 1962b.

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Yesterday, today and tomorrow at the same time the observer and the participant, being part of every action and every figure. This is no ordinary curiosity: it is the classic voyeuristic scenario. The voyeur is not motivated by the real wish-to-know curiosity (epistemophilic instinct).139 Instead, the voyeur penetrates the scene, controls and distorts it. The primal scene, as represented in the mirror, is a grotesque and perverse scenario, dominated by the patient’s projections. This is also the reason why the observer, the voyeur, is so irresistibly drawn to the scene. When the projections are so massive that they exercise an irresistible pull on the subject (what Wollheim calls the ‘lure of the object’),140 the patient is a victim of her projections so her masturbation and the fantasy are compulsive.

I think that the transformation in the mind of the analyst in the material presented refers to the projection into the analyst, not of the patient’s infantile curiosity, but of the patient’s perverse voyeurism. And I think the transformation which happens in the analyst’s mind is a conversion of voyeurism into normal curiosity. After an initial moment of excited curiosity, Mrs Malcolm understood the material; but of course she did not stop being curious. One cannot imagine an incurious person being a good analyst, but the analyst’s curiosity was concerned with actually finding out about the patient and her fantasy and not voyeuristically perverting it for her own use. That would be my first point. Most of the time, we do not know what is being transformed in us. It is an unconscious process and it is sometimes easier for a third person to see. My second point is about the existence in the patient’s scenario of observers who are not being drawn into the scene.These observers are also parts of herself. The patient introjected from the analyst a healthier form of curiosity. But this attitude was not only introjected. I think the introjection of the analyst’s functioning had to meet, and reinforce, some healthier parts of the patient which were already present. I make this point because it seems to me that when we speak of the patient – or the infant – introjecting the maternal capacity for

139 Meaning the drive to explore the world, to satisfy inherent curiosity. 140 Also discussed in the paper ‘Acting on phantasy and acting on desire’ in this book (Chapter 9).

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containment and the alpha function, this process would not be possible unless the introjection was ego-syntonic, in the sense of meeting something in the patient’s ego that was similar. I think an infant totally devoid of a capacity for alpha function could only introject the maternal containment and alpha functioning as a totally foreign object, and not be able to assimilate it. I want to refer here to an unpublished paper by Giovanna Di Cegli on the symbolon (the origin of the word ‘symbol’): it is half of a baton in a relay race, in which one runner passes to the next one the other half of the baton; the two halves have to fit. There are two kinds of introjection intrinsic to projective identification: one I call the ‘takeover bid’;141 and the other is the inevitable re-introjection of an object filled with projective identifications – what I have called a ‘saturated object’.This kind of introjection is one of the roots of the persecutory superego. And such introjected objects acquire enormous powers over the ego. This we see, in the case of Patient X., in the whole mirror scene which dominates her. The other kind of introjection that Mrs Malcolm describes is introjection of the analyst’s function. Bion speaks of the introjection of the container, which would allow for the mental space in the patient’s mind and a container capable of exercising the alpha function.There is some disagreement among other writers about whether the container is introjected as an object, or whether only the alpha function is introjected. There are not only different types of introjections, but the nature of the projection is also important. Bion describes three kinds of relationships to a container. I think this is both too general and too specific. For instance, his own description of pathological projective identification linked with fragmentation of the ego is not covered by the three types he describes.The crux of it is the degree of omnipotence in the identification. For the infant (or the patient) to have an experience of the projected part being contained and understood, and transformed by the understanding, there must be from the beginning some capacity for recognising the separateness between the projected part and the container. If the degree of omnipotence is such that no differences are recognised, then either the container is taken over by

141 Sodré, I. 2004.

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the projections, and becomes identical, like Patient’s X.’s mirror; or the containing capacities are taken over, maybe like the frame of the mirror.To be introduced in what is a constructive way, the container and its function must be experienced as separate, and, at least up to a point, different from the self.The differentiation and the capacity for differentiation must exist from the start, or projection would lead to a vicious circle. And of course the crucial battlefield for this differentiation is the depressive position. Very often, when we discuss projective identification, we do not differentiate enough between the nature of the projective identification as it undergoes an evolution from the early schizoid position to the depressive position; because, like the poor, projective identification is always with us. It evolves, and the evolution is characterised primarily, I think, by its diminishing omnipotence.And this is quite clear in the two cases presented by Mrs Malcolm. Pursuing her theme of undoing projective identification, she emphasises the likeness between the two patients. In fact, they both identify with the primal scene and project left-out feelings into the analyst. But I want to emphasise the differences. First, what is projected? In the case of Patient X., voyeurism; in the case of Patient B., something different.

Case material Patient B. says her children are affected by separation: the husband is made to feel left out. He is made to be jealous. One would assume that she is identified with a much more normal oedipal couple when she inflicts these feelings on her children, her husband and her analyst. What she has projected into them are the more normal, bearable feelings of leftout-ness, longing, being jealous – the more normal oedipal feelings of theleft-out child. The patient is also aware of these projections and feels guilty about them. She withdraws the projections easily, partly out of guilt and concern for her objects. Mrs Malcolm says this patient made an almost total identification with the oedipal scene. To me the ‘almost’ is the crucial difference. When this patient projects, it is not total; she is not completely identified, and she does not completely identify her object with the projected part. She retains her own sense of their differences and their otherness. This ‘almost’ is the dividing line between psychosis and neurosis. To perceive a little difference between the containing breast

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Models of the mind and mental processes and what is projected initiates a development to an awareness of the crucial facts of mental life, like the difference between generations and genders. As the French say, ‘Vive la petite différence!’

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13 The end of psychoanalysis?

This paper was given to an academic audience at Bedford College in 1996. It is clear from the text that Segal was aware that it was possibly a hostile audience – more intent on wanting to see the end of psychoanalysis than with hearing about the ‘ends’ or aims of psychoanalysis – and so she addresses herself to countering the philosophical arguments against psychoanalysis as well as discussing its aims.

I was puzzled by the invitation to speak about the End of Psychoanalysis. I am not a philosopher of science, assessing the methods and reliability of a theory from an objective – or so they hope – point of view. Nor am I much involved in controversies, whether with serious well-meant criticisms or quite-frequent spiteful attacks. It is not a primary area of interest to me. I hope this does not mean that my mind is quite impervious to criticisms of psychoanalysis, as if it were a religious faith, and that people who question or attack it are committing some cardinal sin. I read a fair amount of better-informed critiques, and often ponder over them. I also follow, in an amateurish way, until it gets too tough for me to understand, some philosophy of science and of mind. I am even blessed with, or afflicted by, a son who is a Philosopher of Mind, which makes occasional discussion of such issues unavoidable. However, to me it is not psychoanalysis, but rather the whole idea of the end of psychoanalysis, that has a biblical, religious ring: God has failed – a disaster or triumph, depending where you are standing. I think I am supposed to be agonised about it, and to be tearing my hair out. Is it the end of psychoanalysis? Actually, I cannot get too heated about the subject. Of course, in some ways, psychoanalysis will come to an end. No theory is some 130

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final solution. In the course of development, all theories become obsolete or superseded. In different ways, sometimes when two theories are in conflict – for instance like the particle and the wave theory of light – a controversy so acute that a physicist took a shot at another over it – then Quantum Mechanics came along, and both reconciled and superseded those rival theories. Sometimes a better theory does take the place of the superseded one, often by taking a broader view. Or new facts are discovered which disprove a theory. On the other hand, no serious theory illuminating hitherto-unexplained facts, which is flexible enough to incorporate new data, initiate new research, alter certain views and come to new conclusions, can be termed useless, or even, as some contend about psychoanalysis, harmful. Even if such a theory in the end is superseded, too much is learned on the way for the theory to be considered as having ended, the way psychoanalysis is supposed to have ended. Einstein has not invalidated Newton. New research has not invalidated Darwin’s theory of evolution. To my mind, psychoanalysis is in the same position.At the moment, psychoanalysis offers the most satisfactory theory of the functioning of the human mind, whatever its physiological basis. We know, subjectively, that we have a life of the mind; and that life is, to me, a fascinating object of study.And in a way it is so for everyone, in everyday life – though not as fascinating as it is to us – who have made that study our profession. But we know that we have minds.We know too that others have minds, which are of interest to us because we interact with them.Therefore we observe behaviour, make guesses, attribute motives to all those of interest to us.And though we often ignore our own unconscious, we readily attribute an unconscious to others. To give a childishly simple example. If we encounter a family in which a father disapproves of any suitor or boyfriend for his daughter, he may be quite unaware that his dislike has to do with jealousy. But any ordinary observer is ready to attribute to him such an unconscious motive. In my view, recognition of the unconscious mental forces is implicit even in Marxism, a pre-eminently materialistic philosophy. If you think of the class war, I do not think Marx supposed that every bourgeois or worker had actual conscious, explicit, deliberate views. The experience of unconscious forces and phantasies is not quite a new discovery. It is implicit in much of our everyday thinking: in 131

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such statements as ‘I don’t know why I did it’, or, ‘He doesn’t know how aggressive he is’, etc. But Freud acknowledged it specifically, discovered its ubiquitous importance, and made a study of it; he revolutionised the way we think of ourselves – in an irreversible way. We acquired knowledge from him of such phenomena as infantile sexuality and aggression, defensive organisations and the recognition of paranoid behaviour. His discoveries pervade our way of thinking, literature, contemporary art, views of group phenomena, etc.What has been learned on the way to formulating psychoanalytic theory will remain with us. I spoke of the survival, or otherwise of a scientific theory. But what is most often questioned is whether psychoanalysis has any claim to being a science.This is the domain of philosophers of science, who may debate it. I said I was puzzled by my invitation to this conference. I suppose you invited me because I have subjective experience of the field and you want to know what an analyst feels and thinks about these issues: to see how my mind functions – the observer observed. I was drawn to psychoanalysis because it was an exploration, exploration of a field which I found fascinating: the functioning of the human mind. And exploration, I suppose, is the primary aim of science: observing phenomena, describing them, and seeking to understand the how and why of what they are.We seek to discover patterns and ways of relating conjoint phenomena, and by doing so, to understand them. Science deals with the exploration of facts and some question whether psychoanalysis is concerned with facts.There is a distinction between Psychology, Social Sciences, Anthropology, etc. and such sciences as, say, Physics or Chemistry.The latter sciences are concerned with material facts. Psychoanalysis is concerned with what the American psychoanalyst Robert Caper has called immaterial facts, psychic facts. If I hate you, or love you; if I experience anxieties, or sadness, or joy; these are undeniably important facts in our existence. They are not material facts; though they may be conjoined with material phenomena like a rise in blood pressure or onrush of adrenaline. They are facts in themselves; but they are facts which cannot be weighed or measured. It follows from this that certain criteria applicable to the material sciences are not applicable to the study of mental facts. One is that mental facts do not lend themselves to quantification. Another is, for instance, that they do not lend them132

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selves to experimentation. In the sphere of Experimental Psychology, what can be experimented with is trivial, and what is important would be grossly unethical to experiment with. We would not, for instance, expose people to starvation, or children to ill treatments, to produce ideal scientific controls for experiments. Also, it is contended that we do not have actual observable data; psychoanalytic data are essentially interpretative. This brings into question of course the role of the observer: the analytical observer who also intervenes in the process.The impact both of the fact of his observation and of his intervention is of crucial importance.We do not have so-called natural instruments with respect to the phenomena observed. Our own mind is both the instrument and the interpreter. But then, do we really have such watertight criteria in relation to the material sciences? In today’s science, increasingly, data are in fact interpretative: to make sense of some dots on a screen; to deduce intra-molecular processes takes a lot of background theory and interpretation. And even in the hard-science fields, interpretations often differ.Also, all data are influenced by the observer, and are open, often, to various interpretations.There is also Heisenberg’s Principle of Uncertainty.The observer – and this is of course what is so often questioned in the psychoanalytic situation – is not, and cannot be, a totally neutral observer.The very existence of the observer impinges on phenomena. An active observer who actually intervenes in the process, of course, is very open to question. However, there is another side to the coin, and that is the psychoanalyst’s constant awareness of the role that he plays. I think no scientist in other areas is more acutely aware of the impingement of his observation on the observed, and more trained to deal with it.The analyst is an imperfect recording instrument in many ways; but in other ways a very controlled one. The way I visualise it is that there is constant interconnection between the patient and the analyst who listens and is aware of the registering and reacting; and another part of the analyst’s mind which observes this interaction.And he is very aware of the interconnecting part of him, the role this plays, and very cautious not to be influenced by it. Another argument often used is that psychoanalysis is not a science because the research is not repeatable by others.This again is not quite so. The psychoanalytical parameters are repeatable, and so is the method of investigation, whatever the individual variations of the 133

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individual patient and the individual analyst. And it is through the exchange of information between the analysts – comparing, contrasting, debating – that eventually a scientific consensus is reached. And over the years many of the analytical views have been altered, though without always questioning the basic premise that there is a mental life: that part of it is unconscious, and that it manifests itself most clearly in the transference. From a scientific point of view, one aspect of the importance of the transference is that the only first-hand observable experience we have of our patient is in the room – in his relationship with us. Everything else we only know because the patient tells us it is so.What actually happens, which we observe, is observed by both of us: the patient and the analyst.What’s more, our observations in the room are subject to intense scrutiny and criticism. Dealing with psychic facts, and interpreting them, inevitably leads to investigating meaning. Psychoanalysis assumes events or actions do have meaning to a person, and the same event may have different meanings to different people.The discipline started with Freud discovering that physical symptoms have psychic meaning for patients, albeit unconscious, and that the apparently absurd outpourings of a madman have an actual meaning to him, and sometimes a communicable meaning, if you listen to it carefully. If the meaning is unconscious it expresses itself and can be communicated symbolically. And the meaning is always a meaning to a person. This is clear in understanding symbolism. It is not a fact that a tower, say, symbolises a penis; but it may be a psychic fact that to a given person it does symbolise a penis, or whatever else. And the interpretative approach to discovering the meaning to persons connected with so-called objective facts is part of the essence of psychoanalysis. I take it that the study of interpretation of meaning is philosophically respectable. But as a practitioner of psychoanalysis I am less concerned with philosophical respectability or scientific status as assessed by others. I am much more concerned with the question of what are our ends. What are we aiming for? Are we aiming at finding out things? At helping the patient? Or do we also have more personal motives, like desire to be right, or personal glory? I think our motivation must always be under scrutiny, both in personal analytical work and in assessment of psychoanalysis as such. I think that the legitimate aims of psychoanalysis are Research and 134

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Therapy. It sounds as though there is a contradiction between the two. Research aims at impartiality, in a way impersonality, the satisfaction of one’s own scientific curiosity. The therapeutic aim is almost the opposite: interest in the other, of a non-detached kind – the wish to help, to do what is for the best, etc.Again, as a practitioner, I can only speak of my experience. What led me to become a psychoanalyst was curiosity, exploration, the wish to know and a wish to be in a therapeutic relationship. But, in fact, I do not think there is any contradiction in psychoanalysis between those two aims. One of Freud’s greatest discoveries was that insight is therapeutic. Bion142 once put it that the mind needs truth the way the body needs nutrition.We do speak of giving ‘food for thought’.We also know that there is no such thing as unalterable Truth, with a capital ‘T’. The truth about oneself may vary at various stages of development, and in some ways from day to day. No final truth ever emerges. In our obituary for Melanie Klein, Bion, Rosenfeld, and I formulated it as follows:‘All scientific work has as its aim to see life “as it is”. The peculiarity of psycho-analysis lies in our belief that such an aim and its steady pursuit is restorative’.143 This tenet is fundamental. Acquiring the habit of searching for truth is one of the ends of psychoanalysis.What I am more concerned with, and I think this is true of most analysts, is not the end or otherwise of psychoanalysis, but the constant examination and re-examination of the tools that we use in the search.This necessitates a constant re-examination of ourselves, since our minds are the tool of enquiry, but also of our methods of observation, techniques of interpretation, etc. The question in my mind is not so much ‘Is it the End of Psychoanalysis?’, but rather, ‘What can we do constantly to improve our tools for achieving our Ends of Better Understanding?’

142 Bion, W.R. 1965. 143 Segal, H., Rosenfeld, H. and Bion, W.R. 1961.

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Segal has never written a main paper specifically on technique although of course it is everywhere evident in her work.144 The pieces in this section were commissioned for conferences and provide a rare opportunity to ‘hear’ her discuss technique directly. The section begins with Segal’s important 1990 clinical presentation ‘Model of mental functioning and psychoanalytical process’ (1992) which was given to the American Psychoanalytical Association. American and British psychoanalysts who were there commented that it was a watershed in the reception of Kleinian thought in the USA. Until this point Klein’s work had been viewed with considerable suspicion by American psychoanalysts. Questions of technique are also addressed in the further three pieces of the section. In ‘What is therapeutic and counter therapeutic in psychoanalysis?’ (1987) Segal argues that insight is the specific therapeutic factor in psychoanalysis. In answer to critics who see insight as predominantly intellectual, Segal’s view is that insight is a deep, meaningful and emotional experience. ‘The “corrective emotional experience”: comments on the technique of Franz Alexander’ (1990) is a critique of active techniques.The final piece of the section, 144 Segal has written two papers on Melanie Klein’s technique. The papers however primarily address theory rather than technique: ‘Melanie Klein’s technique’ in Psychoanalytic Techniques, ed. B.B. Wolman, New York: Basic Books 1967, republished in The Work of Hanna Segal and ‘Klein’s technique of child analysis’ in The Handbook of Child Psychoanalysis, ed. B.B. Wolman, New York: Von Nostrand Reinhold, 1972, republished in The Work of Hanna Segal.

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‘The role of child analysis in the general psychoanalytic training’ (1972) includes a discussion of child analytic technique and infant observation.The paper is unusual in that it describes material from both a child patient and an adult patient. Segal discusses how the psychoanalysis of adults has been informed by work with children and vice versa. She advocates a key role for infant/child observation in learning the technique of being involved and yet detached and not having recourse to action.

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This paper145 was presented in 1990 during a biannual meeting in New York of the American Psychoanalytical Association entitled ‘Freudian and Kleinian Theory: A Dialogue of Comparative Perspectives’. Both Hanna Segal and Edward Weinshel, a senior ego psychologist and Head of the Board of Professional Standards at the time, were invited to give papers which were then discussed by the Panel comprising of Harold Blum, Hanna Segal, Edward Weinshel and discussants Horacio Etchegoyen and Otto Kernberg.

It is impossible for me to do justice to the subject: to describe the model of mental functioning that is at the back of my mind when I am working, in the time at our disposal. I would have to explain Klein’s concept of the transition between the paranoid-schizoid and depressive positions, my work on the changes of the symbolic processes in this transition, Bion’s work on the transformation of beta into alpha elements and Rosenfeld’s discussion of the Kleinian view of narcissism. I shall have to take for granted that you have some idea about the theoretical background. I shall confine myself therefore to a bare outline of how I see the psychoanalytical process.To me at its centre is the transference and its evolution.And by ‘transference’ I do not mean the conscious feelings about the analyst; but unconscious feelings to which the conscious ones are but a pointer – as can be the lack of conscious feelings. 145 Segal, H. 1992b.

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The way we see transference now is not as a linear repetition of real past external events, though that also plays a part. I see it as a projection of the internal world. Not a repetition of events but a reanimation of phantasies around those events which have become the structure of the internal world. Strachey146 described how in the psychoanalytical process the patient projects his superego onto the analyst and reinternalises it, modified by the psychoanalyst’s understanding. Klein’s concept is broader. She sees the transference as a ‘total situation’.147 A whole internal world of objects is gradually relived in the transference, and it is not only objects that are projected into the analyst but, importantly in projective identification, parts of the self. The internal world in the past had been formed by an internalisation of objects altered by projections and had given rise to an internal structure. In the analysis that process is relived and the underlying structure is re-mobilised and hence is open to change. This view of the transference as the core of the psychoanalytical process rests on a particular view of phantasy and symbolism. I do not view phantasy as an occasional occurrence, and therefore the transference as part and one of the aspects of analysis, but I view the unconscious phantasy as the basic matrix of the personality which expresses itself in symbolic ways which may be pathological or constructive. And by ‘phantasy’ I do not mean pure disembodied phantasy, but phantasy as it changes and evolves through interaction with reality. My basic intervention in the session is the transference interpretation. But this is not to be confused, as it often is, with a here-and-now interpretation.What I would see as a complete transference interpretation would involve the past, and showing how it affects the present, and the unconscious phantasy and its interaction with reality in the past and present.The centre of the interpretation would be in that here-and-now with the analyst and showing its roots in the past and its effects on the present. Such an interpretation of course would be extremely lengthy and all the factors are of course not always clear. But eventually this kind of linking is what I would aim at. For instance, an event may occur in the analysis which is

146 Strachey, J. 1934. 147 Klein, M. 1952b.

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experienced in a particular way. Eventually one can see how the patient’s phantasy, with its roots in the past, gives a particular significance to that event, such, as for instance, the absence of the analyst or a failing on his part.

Case material A patient at a Monday session bombarded me with contradictory accusations of intruding on her, controlling her and abandoning her. In the next session the patient reported that after the session she asked herself ‘What was all that about? . . . After all, all you were doing was listening to me and trying to understand and help me.’ What could be disentangled was that after her Friday session the patient met the patient whose session followed hers, and she felt abandoned for the weekend. This repeated for her the birth of a sibling. She was overwhelmed with fury and wishes to intrude into the next session and disrupt it. This wish to enter and disrupt was attributed to the analyst, producing in her a state of confusion between feeling abandoned and that of feeling intruded upon, as well as rage, reproducing her confused state of mind at the birth of her sibling. Following which, she began to see her mother as very intrusive and controlling.

This raises the question of childhood memories. Contrary to a prevalent belief, I do consider childhood memories very important, but particularly those that are re-experienced with full emotion in the transference.When childhood memories occur in a way that is not as clearly connected as in this case the question in my mind is always ‘Why is she bringing me that memory at that particular time?’ And generally I do not interpret it until I can see some connection, or point to some disconnection, for instance, how this memory seems to be unrelated, or suggesting the opposite of what the current situation between me and the patient is, etc. Nowadays most analysts see transference in terms of transferencecounter-transference interaction. We used to think of a patient projecting something onto the analyst; now analysts of many different orientations see it also as the patient projecting into an analyst, that is aiming to act on the analyst’s mind in such a way as to evoke feelings in the analyst which will make him behave in such a way as 141

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to conform to the patient’s phantasy.This acting in may be devised to communicate to the analyst feelings by projective identification.

Case material For instance, a patient of mine whose mother was killed in a car accident when the patient was a child, while she waited for her return impatiently, arranged to miss a session after having given me hints and warnings about her own dangerous driving the preceding day. I had a very uncomfortable twenty-four hours wondering what had happened, and particularly what I had done wrong, which could have precipitated an action. The patient was still cut off from a feeling-memory of this experience, but she certainly conveyed it to me very vividly, by making me experience what she felt as a child.

But not all acting in is meant to be a communication. It is often meant to control, and in particular to force the analyst to move out of his psychoanalytical stance. This also becomes a communication when the analyst understands it, but it does not necessarily follow that it was meant as a communication.This acting in is inevitable. It is part of a non-verbal communication. However, it can also be used as a resistance to understanding.The analyst’s role is to understand those happenings in the session and convey them to the patient in a way accessible to his understanding. To summarise, my model of the psychoanalytic communication is that the patient projects into the analytical situation his internal world, and tries to make the analyst conform to the various roles allotted to him. The so-called ‘therapeutic alliance’ is for me the alliance between the analyst and that part of the patient which is in search of the truth.

History My patient is an attractive 40-year-old woman. She is married and has children. Her father died before her birth. Her mother gradually emerged as inconsistent in her relation to the child. She could be quite warm and understanding, but much of the time she was cut off and, though not overtly depressed, withdrawn.

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Psychoanalytic technique Recently a more intermittently manic picture of her mother emerged: she was overactive and the patient had memories of her having quite a busy social life as well as some lovers. The patient was breast fed, but weaned rather early, and when she was one her mother returned to work, upon which the child developed severe asthma, eczema, and constipation, which lasted throughout her childhood. Her mother re-married when the patient was five, and soon after the remarriage she had a miscarriage. There was another pregnancy and a second daughter was born when the patient was about six and a half. She was seduced by her stepfather exhibiting to her. In her memory it was with the mother’s second pregnancy, but her dreams and associations indicate that it probably started with the first pregnancy and that the patient attributed her mother’s miscarriage to what was going on. There is a very strong bond between the sisters, mutually possessive, homosexual in feeling, and intensely ambivalent and anxious. Her relationship to the parents was very bad, her stepfather having turned against her and her mother siding with him and not understanding her difficulties. She did very badly at school, and was anxious and withdrawn. In adolescence she became promiscuous, and she spent a couple of years in what she calls a ‘spaced-out’ state, with drug addicts, etc. though she herself never became an addict. She came to England with the specific purpose of getting herself out of this state and to have analysis. Her biological father had left her a little capital and she intended to spend it on analysis and education. She always hoped that when she had sorted herself out she would go back to re-establish a better relationship with her mother, and she was shattered when her mother died of a brain tumour at a fairly young age, before a proper reconciliation could happen. Though she did manage to fly home and be with her mother in the last few weeks of her life. She had several not wholly successful or failed analyses. When she came to see me, her marriage was failing and she was very depressed.

Analysis The material presented is from the patient’s fifth year of analysis. I cannot describe the course of the analysis, for instance the traumatic effects of her seduction by the stepfather, her relation to her sister and many other significant events in her life. At its briefest we discovered at

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Yesterday, today and tomorrow the very core of her personality a relation to an idealised breast-mother and split from it a depressed, destroyed and persecuting one. Much of her pathology was linked with defences against that core. There was a flight to delinquent and slightly perverse sex, repeating an aspect of her relation to her stepfather, and containing a projection of infantile perverse aspects of herself – a conspiracy against the pregnant mother. There was a tendency to withdraw, often linked with a phantasy return to an idealised fusion with the part-object mother (often expressed in the analysis as a wish to leave and go to Queensland, where she has rich friends and could live in luxury). And there was a homosexual turning to twin-like sister figures, in which she would try to reproduce a reversible relation of baby and mother, whilst at the same time enter into a conspiracy against the real mother. There was also a very defensive use in compulsively having babies. Whilst waiting for her vacancy with me she got pregnant again, which nearly destroyed an already very rocky marriage. Whilst having a baby she would exclude her husband, made into an unwanted third. Potent men figures were absent in the world of her mind, as they were in reality in her childhood. Important changes have happened in her life in the course of her analysis. Her marriage is restored, and recently her husband said, ‘Thank her for giving me back a wife.’ Her relation to the children lost its overpossessiveness, over-controlling and over-ambition, and her professional work is developing well. In the analysis her idealisation of her mother/me in flight from the depressed and persecutory aspect of the transference has very much diminished, and gradually I have been experienced increasingly also as a potent male figure. The Oedipus complex began to appear in its more normal aspect, and there is now a constant fluctuation between facing the oedipal situation and regressing from it. I hope to illustrate this in the session that I will present.

Session The session was a few weeks before a holiday. On the day preceding it, the patient was concerned with having been excessively severe to her adolescent daughter, who was fooling around with a boy instead of doing her schoolwork. The patient realised that she over-reacted and was

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Psychoanalytic technique completely crushing to the child, wanting to make her feel worthless and useless. Next day, she started the session by reporting a dream. She said it was unusual that she dreamt almost directly about me. In the dream, coming into the hall on the way to the waiting room, she saw on the table a birthday card. It was a Polish birthday card. She was very curious and fought against the temptation to turn it over and read it. Finally she compromised, turned it over and just read the signature. It was SALMAN RUSHDIE. She said that in the dream she was quite unaware of the significance of that name, but on waking she became aware of what it meant and felt quite shocked and ashamed. Then she laughed. I asked what was the significance which was so obvious to her. She said, ‘Well, obviously I must be feeling murderous to your husband about the break.’ The birthday card reminded her that she was always curious about what language my husband and I talked to one another – English or Polish. It also reminded her that it was probably the time of my birthday. (The previous year, the patient heard about a birthday party organised for me by my ex-students and she felt bitterly excluded. Resentment about it resounded in various ways for a long time.) She thought Salman Rushdie must represent my husband. As she was talking what floated into my mind was that the patient had behaved to her daughter with the particular kind of self-righteousness that sometimes takes her over – a Khomeini-like attitude. I was also suspicious about the ease with which she spoke of murderous feelings to my husband and her laughter as she recalled the dream and its meaning. I thought the laughter was partly the relief one experiences with insight that is shared, but partly it seemed to me defensive – a sort of ‘yes, of course we know that I am murderous about the holiday and murderously jealous of your husband’. And so I drew her attention to the particular kind of death threat that Rushdie is subject to – not a violent, murderous, jealous attack but a fanatic inflexibility accompanied by righteousness and moral superiority. She then shifted on the couch and said, quite seriously at that point, that of course there is another aspect to Salman Rushdie – he is under housearrest, completely imprisoned and incommunicado, and that in turn made her think of The Collector, Fowles’s book and film, in which the Collector catches a woman like a butterfly and keeps her imprisoned till she dies. By that time, the patient had become very aware of her excessive reaction to all breaks and her extreme possessiveness of me, as well as the intrusive curiosity which is referred to in the dream.

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Yesterday, today and tomorrow I interpreted that Salman Rushdie was not only my husband but that he represented my freedom of thought and movement. When I go on my holiday what is hateful is not only the existence of my husband by itself but that my going with him, as she assumes, reveals my freedom of choice, thought and movement. The patient shifted on the couch and said, reluctantly this time, ‘I suppose so . . . when you started speaking I felt irritated and thought “why isn’t she content with my understanding that Rushdie is her husband; why does she want to drag herself in as well?”’ And she went on: ‘It is not only your husband, you know, it is your papers, books; they keep appearing. I cannot keep up with you. I can’t compete.’ (The patient has an ambition to be a writer, and often feels desperate when she is blocked in writing.) ‘And your students – I keep hearing about them. I have just heard that S (a man she greatly admires) was your candidate. You are just like X, fertile as a rabbit, having a baby every year!’ I said, ‘So my holiday could turn into that kind of birthday party – new babies being born’. There was a silence. After about five minutes she moved her head impatiently, and I said, ‘Yes?’ She said reluctantly, ‘I was doing the usual Khomeini to myself. (Selfattack and self-depreciation are a constant feature of her depressions.) I thought I would never be any good. The holiday is coming and it will be a disaster again. I will be depressed or violent, or both, or take it out again on a kid like I did yesterday.’ She did not seem to me actually depressed. Her expression was rather angry and obstinate. And as she ended on ‘taking it out on a kid’ I said, ‘And you are taking it out on me now. If I fool around sexually with a boy, instead of attending to my work, which is analysing you, you will make me feel guilty and delinquent in taking my holiday, and worthless, as the useless analyst whose patient will be ill again.’ In the past, the patient was always unwell over the holidays – often manic at the beginning and getting very depressed towards the end. There was invariable acting out with family and friends. As time went on, the holidays became less catastrophic, though always disturbed. In my counter-transference, however, I was not as worried about her as I had been in the past. I felt that her associations were more of an angry threat.

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Summary of later sessions The rest of the week was mostly concerned with her relation to a depressed mother, and it emerged that it is the depressed mother who in fact is idealised. A couple of days after the session I have reported, she started a session with very dispersed associations, showing overactivity and lack of connections of a kind that was frequent at the beginning of her analysis, but rare by now. I noticed, however, that en passant there were some references to her mother-in-law, who had come to stay with them. This mother-in-law was always experienced by her as rather depressed, very possessive, overbearing and controlling of her son. She dreaded her visits. So I pointed out to her that among all her many activities she mentioned a few times her mother-in-law but avoided telling me more about her visit, as well as keeping out of touch with me, as though I was this mother-in-law. She said, ‘You are right. I am avoiding thoughts about her, as though she was a spider in a corner, a Black Widow spider. And you are not looking quite yourself today.’ In the next session she told me more about the visit. The mother-in-law came to stay with them (she lives abroad) because she was bringing a friend’s child for a consultation in London. The child probably has an inoperable cancer. She was bringing him to London because the boy’s mother at the same time is herself dying of cancer. The patient said that her view of her mother-in-law has started changing recently. In fact, she was looking very ably after the little boy and carrying the depression without unduly intruding into the family. When the patient had had a miscarriage she looked after her with a lot of understanding. Her motherin-law had also recently cleared the patient’s back garden of widow’s weeds. The patient wondered why she herself never pulled out those weeds, as though she wanted to cling to some dead roots, or maybe did not want to expose them. I drew her attention to the Black Widow spider and the widow’s weeds, and suggested that though she felt tremendously persecuted by this widow figure maybe she preferred to keep her mother-in-law (who is not in fact a widow), but particularly me, as a widow, since the alternative was my going away with my husband on a holiday. She laughed, and said, ‘When we were in the car yesterday my husband, who was driving, put an arm around me, and Johnny (her

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Yesterday, today and tomorrow youngest child) said, “Watch out, Dad, you are going much too fast now.”’ In the next session, the theme of the weeds came again. She was furious with a friend who was always showing off, showing her a tree in her garden which was covered by a climbing plant, wanting her to admire this beautiful silver decoration. My patient angrily told her that they were weeds. I connected it with her wanting me to be a widow and herself an idolising child – a mutually parasitic relationship. She then remembered a time when she went with her mother to hospital. They were sitting in a dreary waiting room, both depressed, clinging to one another. Now she thinks it is horrible, but at the time it felt exquisite. So I could point out how deadly was her idealisation of me, always with her etc., and how it was condemning us both to perpetual depression. For the rest of the time until the holiday she pursued this theme. For instance, there was a dream in which her mother-in-law was holding Johnny on a cliff, and they fell, though the fall was mild. Her association was to the dread of the holiday (the fall from the cliff and hoping that it would be mild), and again to her mother-in-law being too full of her own depression to hold the child. Towards the end of the session she remembered that there was another bit of the dream: when the mother-in-law and Johnny picked themselves up she realised she wanted her mother-in-law to take him to the top of the cliff again. This session followed one in which she had felt particularly relieved and felt me as being particularly strong and reliable. I therefore interpreted her attack on her mother-in-law, whom she described as having in fact held the ill boy and his dying mother, and on me by whom she felt securely held in the previous session. It seemed that she preferred a situation of both of us falling down. She had started that session by complaining that she had not been picked for a job, so I also related the being on top of the cliff to her ambition, which had been very much the theme in the previous weeks. She had had many dreams of being on the top of towers, and either pushing me off or falling herself. There was a very envious streak in her ambition, first directed at her rivals in relation to me, but soon, when in possession of me, enviously rivalling me. After the holiday she reported that it was the first good holiday she had had since she started analysis. And her account of it was convincing. But

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Psychoanalytic technique she was troubled by a dream. She dreamt that she called me to mend the light which had gone out in her room. I came in, but my husband came with me and we repaired the light. And she was absolutely furious. She was very troubled on waking: why was she furious rather than grateful? Was it because she still needed me, or because it was ‘the bloody couple again’. I said ‘Both’. She still depended on me and she was beginning to realise that for me to function well as a mother I needed the support of my husband and she needed also the support of a father.

Conclusion I have presented a summary of sessions following the detailed one because the session presented did not lend itself to showing in detail shifts in the session. But I wanted to show a certain shift in the course of several sessions. There was a shift from fixation to a depressed mother in the internal world to the appearance of other aspects of the mother. The patient becomes aware that she idealised a state of mutual depression as protecting her from separation, and also from jealousy and envy. There is an emergence of a mother who actually could cope with her own and the child’s depression, as symbolised by her changed view of her motherin-law who could deal with a dying child and mother and who had in the past helped the patient over her desperate depression about the miscarriage. The emergence of that perception of the mother relates to the healthier aspects of her mother, and is reinforced by her analytic experience. The emergence of a stronger mother is also connected with that of a more oedipal situation. This too has some roots in the past: her mother’s re-marriage and earlier memories of some lovers. But it is also related to her phantasies of her mother’s marriage to her father, with whom she is said to have been very much in love, and to the existence in her mother’s mind of a positive perception of sexuality. The black-widow figure, on the other hand, always represented a mother filled with a dead father. In analysis this is represented by the fact of my being married – an external situation – but also by ‘the Freud in my mind’ as a source of strength and its manifestation in my analytic functioning. My patient’s deepest anxiety in this analysis is that under the impact of her destructiveness and/or seductiveness I should either die, like her first analyst and her father,

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Yesterday, today and tomorrow or collapse mentally, as she felt her second analyst had done. Any sign of weakness in me terrifies her. There is also a change in the transference/counter-transference interplay. In the early years there was a lot of acting in and out, and communication therefore was predominantly by projective identification. Hence a highly-charged counter-transference reaction. I experienced depression, hopelessness, a great deal of irritation when she was manic and flippant, and a constant experience of an all-pervasive seductiveness. Now the counter-transference is mostly a fleeting indication of what goes on, and the communication by dream and association is clearer.

Postscript 2005 In this presentation I have tried to show how the patient has a psychotic identification with a depressed mother underlining her various pathologies. This was an identification which she maintained because it served her own narcissistic needs. I wanted to show the audience how important such a nexus is and how it can be relived and mobilised in the transference. I did not take up another theme that was becoming evident, that of the patient’s hidden compliance. She did not overtly comply but she always provided extremely helpful associations or further developments to what I was talking about. It is often difficult to differentiate what is actual co-operation and what is another kind of process. Whilst being genuinely co-operative on the one hand the patient also adopted my interpretations in order to make us be of one mind and thus regain another kind of narcissistic union with her mother.

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15 What is therapeutic and counter therapeutic in psychoanalysis? 148

This paper was given at a British Psychoanalytical Society conference on Saturday, 14 November 1987.

This Symposium has for me a déjà vu feeling. In 1961 I took part in the International Congress Symposium on Therapeutic Factors in Psychoanalysis.At that time I contended that Freud’s basic proposition that insight is the specific therapeutic factor in psychoanalysis still holds true. The paper was controversial in that other views were represented, such as, that it is the relationship that is therapeutic or the love of the analyst, as expounded by Nacht.149 My view was that all those factors are inter-related in that insight develops in a relationship and in turn affects the nature of the relationship. Basically I still hold this view. It is insight that enables the analysand to regain parts of himself lost by projections, to integrate what has been fragmented or split, and this in turn alters his perceptions and object relationships. Insight is also of importance for lessening omnipotence and allowing a non-pathological introjection of the functions of the analyst. However, when one speaks of insight, even if one clarifies that insight can only be gained by experience, the impression is always left that insight is something predominantly intellectual. So in this contribution I would like primarily to expand

148 The Bulletin of the British Psychoanalytical Society, 1987, Number 9. 149 Nacht, S. 1962.

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what I meant by meaningful insight. Such insight can only be achieved through emotional experience. The patient experiences different states of mind and through that experience he becomes familiar with and tolerant of various aspects of his personality. In particular, he experiences states of mind which hitherto he has warded off.And experiencing those states of mind he begins to know, not only his impulses and the nature of his relation to objects, but also the kind of characteristic defences he uses which contribute to making him the individual he is.Through his transference experience, he begins to know his own psychic history and how it affects him in the present. Insight is not something achieved once and for all. It is a capacity to recognise and tolerate different mental states.And it keeps shifting and evolving with the evolution of the analytic relationship. Such experiences lead to an increasing integration. Insight is never static and once and for all. I think after the conclusion of a reasonably successful analysis the patient not only acquires some understanding of himself, his ways of functioning, etc. but even more importantly, he acquires the capacity to recognise, and to be more understanding of, his own mental states. And understanding is of importance.When people say,‘Oh, I understand it all but it doesn’t make any difference’, it is not in fact true. Understanding is a new factor which brings about change. For instance, the moment the patient experiences how split he is, he is already on the way to integration. If he understands what he has projected into another person, it alters his perception and his state of mind. In this Symposium our concern is with what is therapeutic and what is anti-therapeutic in the analytical process. If I say that the potent therapeutic factor in an analysis is insight, I have to address myself to what it is in the psychoanalytic situation and interaction that favours the development of this insight. First of all, we must provide a setting which is stable, not intruded upon, etc. And an important part of this setting is a truly psychoanalytic attitude of the analyst. A person cannot allow himself to go through certain emotional experiences if he feels the analyst to be critical or rejecting of them. But equally, he may not allow himself certain experiences if he thinks the analyst can be upset or seduced by him. The stability of the setting allows the patient to gain a growing confidence in the ability of the analyst to tolerate the patient’s experiences and attitudes and experiences which are projected into him without being unduly 152

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affected. Such an attitude by itself tends to diminish the patient’s belief in his omnipotence and lessens the anxiety deriving from it. And if omnipotence diminishes and he re-discovers, for instance, the warded off helplessness, he must have sufficient trust in the analyst based on good experiences not to dread excessively that situation. I emphasise that trust is based on experience. Some American schools speak of the therapeutic alliance and mean by it that certain measures have to be taken by the analyst, such as fostering positive transference, to make this alliance. I think that there is always a part of the patient that is our ally, or the patient wouldn’t be on our couch at all. But a true therapeutic alliance is forged as the analysis evolves and elements that interfere with the alliance, such as persecutory anxiety, are analysed.The alliance is not static but subject to fluctuations and the analysis of these fluctuations is an important part of the analytic work. In order to provide this kind of setting, which primarily is the mental setting in the analyst’s mind, the analyst must have what I would call a good counter-transference disposition. Nacht’s view,150 that the analyst’s love is therapeutic, could be right in the sense that the good counter-transference disposition is one in which the analyst’s unconscious, in his relation to the patient, is predisposed to receptivity and understanding.That I think is the expression of ‘love’ appropriate in a psychoanalytic treatment. It’s easiest for me to think of this good counter-transference predisposition in Bion’s terms of the ‘container’ and the ‘contained’.151 The analyst is identified with the containing capacities of parental objects and his own analyst. It means the analyst is able to contain his own infantile experience, and those that resonate with what is projected by the patient, without it leading to a disruption of his containing capacities. In other words, the analyst’s state of mind corresponds to what Bion called ‘reverie’.152 If this is the basic unconscious stance of the analyst, then the patient’s projections can be understood and elaborated. However, this containment is frequently breached by the concreteness or violence of the patient’s projections and it leads to the analyst acting out, however discreetly. By discreet acting out I mean such manifestations as: a 150 Nacht, S. 1962. 151 Bion, W.R. 1962b. 152 Bion, W.R. 1962a.

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change of voice we may not even be aware of, formulations too harsh or too caressing, interpretations which are wrong or at the wrong level etc. These occur in all analyses, however strict the psychoanalytical attitude and avoidance of more obvious acting out. And it is essential that the analyst recognises such situations in which his containment was breached and uses that in turn for understanding the interaction with the patient. But the analyst’s receptivity and containment are only the first step in the analytical process, the ultimate aim being the patient’s increased understanding. The patient himself cannot reach his warded off experience without the help of the analyst and in the psychoanalytic interaction a crucial role is also played by interpretations. One can think of it as the breast being the container and the nipple the instrument of feeding, or as the maternal and paternal function of the analyst. Being receptive and silent is not always containing. The containment is in the understanding. I once had in analysis a mildly borderline patient who was in treatment with a totally silent analyst. In this situation, inviting regression and projection, she started hallucinating on the consulting room’s wall. Fortunately, she was strong enough to interrupt the treatment before a complete psychotic breakdown occurred. In her later treatment with me she did well, as her projections into the analyst found a response which was not a blank wall. At some point the containing parent takes appropriate action to communicate her or his understanding. The appropriate action for the analyst is the interpretation.Whether to be silent, when to interpret, at what level, are decisions that have to be constantly made, and to make them the analyst is guided by his intuition based on knowledge and experience. A crucial role in psychoanalysis is played by psychoanalytic intuition. A creative scientist must be capable of an intuitive leap which then has to be tested by experience. But a less creative scientist can work by pure deduction. This is not so in the case of the practitioner of psychoanalysis. The psychoanalytic process is always creative and always a process of discovery in which intuitive capacities are central. These capacities must depend on many factors, such as, the good counter-transference disposition, which goes also with the good internalisation of psychoanalysis, the analyst’s experience and whatever it is that makes for psychoanalytic gifts. 154

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These emotional factors are sine qua non. There are however also intellectual necessities. I think that one’s conceptual armoury plays an important role. I have seen gifted, well-disposed analysts completely missing the right level of communication through lack of adequate concepts. A typical example is what used to happen in the past to patients with acute erotic transferences. If the analyst took up the obvious oedipal material in the best possible way, it was experienced by the patient as a sexual seduction or assault and sometimes led to acute psychotic breakdowns. This was so because there was no conceptual apparatus to understand part-object relationships and psychotic projections by the patient which made them experience interpretations in a concrete way.

Case material I shall give you two brief examples of the importance of interpretation, or even of commenting at the right level. The first comes from work of a candidate. He was confronted by a patient starting his analysis in an acute homosexual panic of a psychotic kind. He objected to using the couch because he was tired of being a faggot and lying down for men, etc. He was clearly dreading the analysis as being forced into a homosexual submission by the analyst. The candidate interpreted, ‘You are afraid that I am not able to distinguish between the psychoanalytical situation and a homosexual assault’. The patient immediately relaxed, staying on the couch, and started associating in a less psychotic way. I think the candidate got absolutely onto the right level of experience. He did not take up the patient’s fears, didn’t interpret at that point projections, but contacted the patient’s fear of concrete thinking in the analyst. It was only later that he could address himself to the patient’s own concrete thinking and the projection of that into himself. This patient reminded me of Schreber153 explaining that God was unable to understand symbolism and metaphoric thinking. The opposite happened to me, making a comment which proved counter therapeutic. A patient on the brink of a severe manic breakdown rang me in the evening to reassure me that he was all right. I felt it necessary to communicate to the patient that I didn’t treat his ringing me as an intrusion, but rather as a positive 153 Freud, S. 1911b.

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Yesterday, today and tomorrow step. So, in a comment, I used the expression ‘that he wished to maintain contact with me’. My use of the word contact turned out to be most unfortunate. The next day when the patient had broken down he was persecuted by electric wires driving through his brain, producing short cuts, etc. I obviously hadn’t realised how concretely the word contact could be experienced. I was very well aware that I must never with this patient use the expression ‘get in touch’, as it is immediately erotised and experienced as a seduction. But the possibilities of the word contact had escaped me. Probably I should have spoken of communication. It seems to me that both the candidate and I had a sufficient conceptual apparatus to understand the problems and pitfalls in the choice of language in talking to our patients, but his psychoanalytic intuition led him to a correct formulation and mine let me down.

So, to summarise what would I consider therapeutic in the analytical situation: it is everything in the setting and the work which helps the patient to feel, to express himself freely, and to become more self-aware and everything that promotes the analyst’s understanding and meaningful communication. It is fashionable nowadays to speak disparagingly of ‘clever interpretations’. If the ‘clever interpretation’ is out of touch with the atmosphere of the session and the patient’s feelings, then it is not clever, it is merely a bad interpretation. An intelligent interpretation, however, which shows understanding of the patient’s feelings and defences, is not to be dismissed as clever clever. An interpretation of the right content and at the right level is the central therapeutic factor. It is the very basis of the psychoanalytic method. What then would be counter therapeutic? I think the way the title of our Symposium is formulated invites us to consider not only the analyst’s countertherapeutic attitudes or interventions, but the whole question of whether the psychoanalytic situation and process by themselves could be counter therapeutic. I think it is the same factors which are at the crux of a potentially therapeutic situation, which also have the potential to make a counter therapeutic one. It is the interrelated factors of the regression produced by the psychoanalytical treatment and the effects of the transference. If regressive phenomena are not understood and well handled, they can lead, for instance, to a decompensation of the mechanisms of defence and possibly irreversible disintegrations. 156

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Transference is a danger in that it confers enormous powers on the analyst and the patient is vulnerable to the analyst’s wrong responses just as he was to the responses of his parents.The powers and weaknesses of the patient and the analyst interact. The power of the patient’s projections may affect the analyst and, as the patient is dependent on him, he becomes the victim of the analyst’s response. The regression to dependence and the transference of infantile attitudes to the analyst cannot be avoided as they are the fulcrum of the analytical therapy. For the therapeutic use of the situation, there is a need of at least some co-operation on the patient’s part, but the major onus is on the analyst’s work because the patient only partly wants to get better.The forces in him which led to his illness are still active and he needs the analyst’s understanding to enable him to face them.The analyst’s counter-transference is always under strain.The patient unconsciously always pushes the analyst to act out a role in the patient’s internal drama. For instance, he may be pushed to act out a punitive superego.This can lead to prolonged sado-masochistic ties. On the other hand, the analyst sometimes cannot help sounding to the patient like a superego when he interprets to the patient the existence of negative feelings or his acting out of these feelings, or generally interprets what the patient, for good reasons of his own, does not want to know about. Some patients, some of the time, experience such interpretations with relief. Other patients always, or some patients some of the time, can only experience such interpretations as an attack by the superego.And this too must be carefully followed and interpreted to diminish this superego effect.

Case material One of my patients came to understand that as far back as he could remember, and probably long before, he experienced all reality as a vicious vengeful attack on his omnipotence – his comeuppance. This trulyfelt understanding enabled him to tolerate and accept what had been earlier experienced as cruel and attacking interpretations and to spot himself how he turned them into persecutions. Another patient for many years could turn anything or nothing into a persecution, and any interpretation of her denied or projected good feelings was treated as a sign of weakness, stupidity, wish to placate her, etc. She made very, very slow

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Yesterday, today and tomorrow therapeutic progress which made her external life more liveable. But there was no lasting structural change and the psychoanalytic situation was stuck. I reached a point where I realised if the patient stayed in analysis it could prove counter therapeutic. Outside the analysis her relationships broke up and people avoided her. In analysis she found an object she could endlessly exploit and ill-treat without being left. The sadistic pleasure she derived from it gave her a kind of haven that she intended to keep forever. When this became crystal clear to both of us I decided to stop. That this situation could not be resolved shows the limit of an analysis. It could be my own limits, and another analyst might have done better (though she had seen three good analysts before me), or it could be the limits of our knowledge today.

Like all potent therapies, psychoanalysis has its dangers. There are some dangers in interpreting. There are also dangers in not interpreting which blocks the patient’s development and leaves him alone with his despair. Under interpreting – pussy footing – also leaves the patient alone with his problems. If the analyst can’t bear speaking clearly, it confirms the patient’s feelings that his thoughts or feelings are unthinkable because they are unsayable. It also brings about an element of unconscious collusion, particularly in the erotic sphere – a kind of atmosphere which says – ‘We both know what’s going on but we shall not speak of it clearly so we can carry on pussy footing’ and this can also be very cruel. I once told a candidate a joke about a masochist and a sadist.The masochist was writhing on the floor saying, ‘Beat me – beat me’ and the sadist, his hands in his pockets, said, ‘I won’t’. I suggested that his pussy footing had the same effect. I only touch on a few points on the therapeutic and counter therapeutic in analysis, focusing my comments on the problems of regression, transference, dependence and the analyst’s reaction to projections. I would like to conclude on a simple remark Mrs Klein made in a discussion. She said mistakes are unavoidable.We all know that. But by and large, the more mistakes you make, the less good your analysis. And the fewer mistakes, the better your analysis. Psychoanalysis is a very potent treatment, involving a lot of responsibility.Too many or too great mistakes are dangerous to the patient. So both individually and collectively, we must always take very seriously the sources of our mistakes and try to understand and derive more insight from them. 158

16 The ‘cor rective emotional exper ience’: comments on the technique of Franz Alexander

Franz Alexander was the first graduate of the Berlin Psychoanalytic Institute where his training analyst was Hans Sach. In 1929 Freud invited him to Vienna as his assistant, but he chose instead the University of Chicago where he became Professor of Psychoanalysis. In his 1946 book Psychoanalytic Therapy Alexander proposed the concept of ‘corrective emotional analysis’, a technique in which the analyst purposely behaves in the transference in a ‘corrective’ manner towards the patient. This approach became known as the Chicago School of Psychoanalysis. This paper154 was originally part of a 1990 special issue of the Psychoanalytic Inquiry on ‘Corrective Emotional Experience’.

It is not easy for me to comment on Dr. Alexander’s technique since I have no first-hand experience of this, nor have I ever had discussions with anyone using the technique. Such knowledge as I have comes from some reading and some contacts with patients who had been treated according to that technique. I have, however, had some experience of discussions with analysts using a variety of active techniques. Some of my disagreements are with active techniques in general, usually derived from Ferenczi.

154 Segal, H. 1990, ‘Corrective emotional experience’: comments on the technique of Franz Alexander.

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I am in agreement with some of Alexander’s criticisms of the classical technique. I certainly agree with him that an analyst is not a neutral mirror on to which the patient in phantasy transfers his past objects, and I agree with him that such a neutral attitude is not possible in reality, nor would it be desirable if it were. I also agree with him, and indeed it is a general psychoanalytic tenet, that psychoanalysis is a corrective emotional experience and that purely intellectual insight produces no change. Certainly, now an increasing emphasis is placed on the nature of object relationships by analysts, classical analysts as well as the so-called ‘object relations’ school. I doubt if anyone today entirely holds the view criticised by Alexander. I differ, however, completely from Dr. Alexander in my view of the vicissitudes of object relationships and how countertransference should be reflected in our technique. In Chapter 4 of his book,155 Dr. Alexander sets out those aspects of his technique which have proved controversial. These include changing the frequency of interviews and temporarily interrupting treatment. He also advocates the principle of applying different techniques with different patients, active help and advice, as well as direct intervention in the patient’s circumstances. The use of counter-transference that he does recommend156 is as follows: . . . the analyst should attempt to replace his spontaneous countertransference reactions with attitudes which are consciously planned and adopted according to the dynamic exigencies of the therapeutic situation. This requires the analyst’s awareness of his spontaneous countertransference reactions, his ability to control them and substitute for them responses which are conducive to correcting the pathogenic emotional influences in the patient’s past. He particularly emphasises that we should recognise the patient’s expectations and act in an opposite way. For instance, to turn to some

155 Alexander, F. 1957. 156 Alexander, F. 1957, p.93.

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paradigmatic cases, in Chapter 3 of his book, ‘The principle of flexibility’,157 he reports on a patient who had a perception of his father as very severe, tyrannical and obsessive.The therapist acted in a particularly encouraging and kind way. In another case, that of a young man who felt guilty because his father was so good, he made it clear to the young man that he disliked him. He also describes another therapist who lost his temper with the patient, with very positive effects. It seems to me that this approach completely ignores the existence of splitting.Where in the patient’s internal world was the good aspect of father in the first case, or the bad aspect of father in the second and third cases? The analyst doing the opposite of the patient’s expectations in these cases acted out the split-off other aspect of the original object, which I think is as damaging as acting out the expected role. In both situations, splits are ignored and conflict avoided. It is my contention that far from giving a corrective emotional experience, such acting out in fact short cuts the experience. Presenting the patient with some firm demonstration ‘I am a good object, not a bad one as you expected’ cuts short any exploration of the splitting process and of what is contained in the bad-object experience of the first case, or the idealised experience of the second and third cases. It also takes for granted that the fathers in these cases were in reality exactly as the patient conceived them. It ignores the fact that transference is not a linear repetition of the real past with the real external object, but a projection onto the analyst of an internal figure with a long history. The real corrective experience would be reliving in the transference how such an object was formed; gradually discovering what were the real attitudes of the father and what was due to the child’s projections into this father; what was denied and where was the other aspect (good object or bad object) projected? It is only through reliving it in the transference that such a figure can truly be modified rather than have one or the other side of the split reinforced. Similarly, Dr. Alexander cuts short the corrective emotional experience when he recommends dealing with the patient’s overdependence on the breast and fear of weaning by cutting down sessions. He cuts out both the patient’s experience of dependence and

157 Alexander, F and French, T.M. 1946.

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cuts out the reliving of the real conflicts of becoming separate, separated and independent. Yet I do agree that we act in a way opposite to the expectations of the part of the patient involved in repetition compulsion. Insofar as the patient is under the sway of repetition compulsion, we do act in a way opposite to his experience, essentially because we do not react. Our basic response is one of containment and understanding; in that way we differ most from all the objects in the patient’s life, whether in infancy or in the present. I think that if we react as Alexander advocates by acting the opposite of what is expected, we do re-enact other aspects of the patient’s unconscious relationships. And that indeed may be unconsciously manipulated by the patient. Presenting oneself as a victim of the father’s tyranny may be devised precisely to call forth a sympathetic response. For example, it could be inviting the mother aspect of the analyst to collude against the father. I think the basic attack on the psychoanalytic understanding of the analyst is to get him to react this way or that way, any way so long as he is displaced from his analytic stance. We now understand that patients project not only onto an analyst, as onto a mirror, but also into the analyst, constantly inviting him to act out. Also they project not only internal objects but also parts of themselves. When the patient sees Dr.Alexander as a violent bad father, what part of it is an experience of a really severe father and what part the patient’s own intolerance and rage? We now understand better that patients project into us constantly, trying to influence our minds and get us to enact some internal drama by any means, verbal or non-verbal.158

Case material I shall give a gross example of such a projection. A patient whose mother died in a tragic car accident when she was a child could not learn to drive. At some point in her analysis, she learned to drive and was coming from outside London to her session on a motorcycle. One day she missed a session without letting me know, which was unusual for her. I spent a very anxious twenty-four hours remembering how she boasted to me in

158 Joseph, B. 1985.

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How should we use our counter-transference? Dr.Alexander does not do justice to Paula Heimann159 when he says that she admits the existence of counter-transference but does not tell us how to use it. In fact she spells out very clearly that our counter-transference is part of our perceptual apparatus. It gives us information about what the patient ‘is up to’, and if we can bear it and understand it then we can share this understanding with the patient and give him a real corrective emotional experience of emotion lived with understanding. Many cases reported by Alexander are of very short duration.They are cases of psychotherapy. Many psychotherapeutic techniques based on some psychoanalytical knowledge are very helpful. For myself, I prefer methods which preserve a more psychoanalytic stance and I am certainly not an expert in the field of brief psychotherapy. My concern is about the introduction of Alexander’s techniques into psychoanalysis. Psychoanalysis is specific in that it aims at structural changes in the internal world. Such changes can only be achieved by the specific psychoanalytic technique. Unconscious phantasies which have become structured in the patient’s mind are re-mobilised and relived in the transference, in which they are contained and modified by understanding. Alexander thinks of psychoanalysis predominantly as a way of relieving repression.This conceptual tool may not be enough to give 159 Heimann, P. 1950.

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access to an understanding of the internal world.Without understanding of splitting and fragmentation, the use of projective identification, and other primitive processes, the understanding of the complexity of the internal world and its re-enactment in the transference-countertransference interchange eludes us, and that is when we have to resort to various actions of the kind advocated by Alexander.

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17 The role of child analysis in the general psychoanalytic training

This paper160 was written for a European Psycho-Analytical Federation symposium on ‘The Role of Child Analysis in the Formation of the Psychoanalyst’ held in Geneva in June 1970. Papers were given by a number of psychoanalysts including Hanna Segal and Anna Freud.

I have a slightly difficult task today because I am supposed to talk about the role of child analysis in the psychoanalytic training of analysts, and this subject was debated at some length earlier in this Congress. Miss Freud kindly said she would be careful not to trample on the territory to be covered by this paper, and she did not; but when it came to the general discussion we did not just have trampling – it was a veritable stampede, and I saw the territory covered by this paper and the discussion disappearing from under my feet. So I have no ambition to say anything original or new today, and much of what I am going to say has already either been said or implied in the previous discussion. I hope, however, that it may be of some use if I bring together certain themes in my own way, and suggest some practical conclusions, this being something that has been touched on but not fully discussed at this meeting. I start with the basic proposition, again not at all original, that psychoanalysis as we know it is a body of knowledge, a theory and a technique.The three are intimately linked and equally important to

160 Segal, H. 1972.

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the training of the future psychoanalyst. Insofar as teaching of the knowledge and theory of psychoanalysis is concerned, one certainly cannot divide such knowledge as has been acquired from the analysis of adults and that which has been acquired from the analysis of children. In the last 30 years in particular, many major advances in psychoanalytical knowledge and theory have been brought about by the analysis of children – advances which have been naturally reflected in changes in technique. The particular contributions of the psychoanalysis of children in Melanie Klein’s early work had a fundamental importance on her later theoretical development. Her original work with children brought fundamental insights into the early processes of the mind. It is in the work with children that she first became aware of the early stages of the Oedipus complex and the superego, of the role of partobjects, and of the overwhelming importance of mechanisms of splitting, projection and introjection in the building up of the child’s internal world. Some of the very important developments which happened in work with children had to do with her discovery of the importance of the process of symbol-formation. This begins in Melanie Klein’s paper, ‘The Importance of symbol-formation in the development of the ego’,161 which was based on the analysis of a 6-year-old psychotic child.162 It opened up a whole area of investigation of symbol-formation and symbol-functioning, an area which was later intensely studied. I think that up to that time we knew a great deal about man as the symbol-user and very little about man as the symbol-maker. And it is the work with children which opened up this very important area in understanding the roots of creativity, sublimation as well as pathology, such as inhibition or lack of symbolformation, which can result, for instance, in the concrete thinking and related phenomena of the psychotic. I think it would be generally agreed today that it is mainly insights derived from the analysis of children that illuminated pre-psychotic and psychotic processes rooted in the pathology of early infancy, processes which are developed and displayed in the consulting room

161 Klein, M. 1930. 162 This is ‘Dick’, the same child referred to at the end of ‘Psychic structure and psychic change’ in this book (Chapter 7).

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by disturbed children, with sometimes quite extraordinary vividness. But of course that is not all: it is in childhood and in early childhood that character is formed and one can observe the interplay of object relations, anxieties and defences being organised into what later become personality and character.

Case material I want to give a very simple example comparing adult material with child material, to bring this to mind. This adult came to analysis without marked symptomatology. He is one of those people who come to analysis apparently for professional reasons of training or the like. His pathology is almost entirely in his character formation. He is rather obsessional and petty, what he himself described as ‘niggly’, nothing that one could describe clinically as paranoid, though that of course would be revealed in analysis. He is a typical sort of obsessional, slightly paranoid, complaining, difficult character. One day, in a typical sort of way, he opened the session by grumbling that there was tobacco smoke in the room, that he saw the maid going up the stairs, which he thought was an untidy way of running an analytical practice, that he did not like the colour of my dress, etc. He also expressed, which was very typical of him, extreme irritation with these thoughts: he said that those were the kind of niggly thoughts that persecuted him and interfered with his analysis, as they interfered in his daily life; and he spoke with great dissatisfaction of an important example of this kind of interference. He and his wife decided not to go away on a summer holiday, because the year before they found the holiday so irritating, with the various petty annoyances, with the hotels, the other people, the changes in weather etc. He felt extremely annoyed about this because he knew that many of his acquaintances were not prevented from having an excellent holiday despite the same annoyances, and he was aware that it was something characteristic of his family that he, his wife and his little daughter were always irritated in this way. He then reported a dream. He was in a lovely buttercup field with his wife and child, but they were very annoyed and frightened because there were wasps buzzing all over the field. He laughed after telling me the dream and said: ‘It’s just what I told you about our holiday; whereas others are enjoying a lovely field, we are annoyed by wasps’. He had

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Yesterday, today and tomorrow further associations to the dream: the yellow of the buttercups and the wasps reminded him of the terminal jaundice of his mother who had died the previous year. Buttercups made him remember that as a child he thought that they were cups of butter. After a pause, he said that the field vividly reminded him of something and he remembered that when he was about four he was taken to the country by an uncle to a yellow daffodil field, which looked just like the field in the dream. He and the other children got very excited and collected armfuls and armfuls of daffodils; then they got bored with them in the car and started playing games of tearing them and throwing them at one another; and when they got home they chucked them out of the window and littered the street. In the evening, through the open window of his bedroom, he heard people commenting on the littered street and wondering who the vandals were that would behave in this way. As he remembered this, he had a very strong feeling of a sort of horror and revulsion at himself and the other children. He said it was the double vandalism that upset him: one was the onslaught (he used that word) on this field which looked so beautiful, and the other was using those beautiful yellow flowers just to make dirt out of them and litter the street. Without going into the details of the session, I could interpret, in the transference and in relation to his mother, the following situation: in the previous session he had been extremely sarcastic and unpleasant to me and I interpreted to him that he felt my room and practice had been spoilt by this attack. I connected this with the attack he felt he had made on his mother’s ‘buttercup’ breast and the urinary and faecal attacks he made on her body (the field), which jaundiced her. I linked this with the field in the dream, in which he is persecuted by the wasps. This field represented to him his perception of the external world, originally his mother’s body. I also interpreted it as his internal world, the field of this thought, in which he always felt persecuted by niggling thoughts, like wasps. It took quite a few of these ‘niggling’ sessions to get at the underlying situation: the field is a holiday field. It is the kind of things that happen to him when the analyst goes on holiday and the kind of relation he has to his mother in relation to early separations – a theme which came into the analysis after these sessions. However, the word ‘onslaught’ that he used here is important because I could interpret to him ‘onslaught’ using his word, but in fact no real onslaught had happened. What I was confronted with was this unpleas-

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It is particularly in work with adolescents that an analyst needs this double perspective with experience of analysing both children and adults. One may then feel more at home in following the changes which sometimes happen minute-to-minute between the adolescent as a baby on the couch, and the adolescent as an adult on the couch. It would be impossible today to teach psychoanalytical theory, of whatever orientation, without including all the developments in theory due to the direct work with children. However, here we come 169

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up against the first difficulty: it is notoriously difficult, if not impossible, to teach psychoanalytical theory without the clinical experience on which it is based.After all, we know that one’s understanding and conviction about theoretical formulations can only be based on the understanding of how the theory derives from, and how it accounts for, actual clinical happenings. It would indeed be very unsatisfactory to teach the theoretical developments other than in the setting of clinical material and examples; the student must always be acquainted with the material on which any theory is based. But this, of course, is only the first part of our difficulty, because we also know that in psychoanalysis there is an organic relation between material and technique, and this is something that other scientists often reproach us with. We know how much, for instance, different theoretical outlooks are linked with, and often spring from, different technical approaches. I think that in order to understand analytical material the student must understand the rationale of the technique.To understand analytical material means, to begin with, to understand what goes on between patient and analyst. And here we come to a second difficulty. Can technique be taught in the abstract without the student having actual technical experience himself? So to understand the significance of child analysis the student would be best served by having actual clinical experience himself. I wondered what the title ‘The Role of Child Analysis in the Training of the Analysts of Adults’ implied: should we talk about what is, should we talk about what should be, and if we talk about what should be, should we talk about what should be ideally or should we talk about what could be? To introduce the discussion I shall say something about all three. Starting with what is, I think that in most institutes we have allowed far too great a gulf to develop between the analysis of children and that of adults. In most institutes that I have visited, I think the enrichment of psychoanalytical understanding derived from children’s analysis is not as fully exploited and used as it should be. In our institute in Great Britain we had for years lectures on child analysis and clinical seminars, which were compulsory for all students. Unfortunately, we are going through one of our periodic great upheavals and reorganisation, and I find to my horror that the child has been thrown out with the bathwater.The course of child analysis for the ordinary candidate has disappeared, I hope only very temporarily. 170

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We have, of course, child seminars for those actually undergoing child training. I would say that the position of what is is that the gap is too great and that we are not deriving all the benefit that we could. Now, as to what should be, I want to differentiate between what I consider would be the minimal requirements and what Miss Freud described yesterday as ideal for the future. Ideally, one would like to see all analysts having a child analysis training. In most institutes, however, we are very far from this ideal. For the minimum requirement, I think theoretical courses should include all the knowledge and theory derived from work with children. Surprisingly I think this is not universally so; there are theoretical courses which take into account little or not enough of these developments.Also, I think that analysts of adults should have regular baby and child observation. (This is something that we do have in Britain, at least the first part of it: a weekly seminar of baby observation for a year is compulsory for all candidates.) Baby and child observation is of great value from three points of view. Firstly, the first year in most institutes – it is certainly so in ours – is a pre-clinical year and it tends to become very theoretical. Having actual baby and child observation in this year keeps the young analyst in touch with the fact that analysis has to do, first of all, with people and only secondly with theory. Secondly, much can be derived from the actual observation of how babies and children behave. Thirdly, it is an excellent preparation for an analyst. It is extraordinary the degree to which people are unable to observe and how long it takes for them to learn to observe. Perhaps surprisingly, candidates with medical backgrounds are no better than non-medical candidates. I think it may have to do with the fact that medical training has to do with a kind of active observation – the things you look for. Medical observations are usually of short duration, while the baby or child observation is much more like analytical observation. It is this situation of being involved and yet detached and not having recourse to action which is an excellent preparation for analytical work. So, for my minimal requirements I would say: first, full integration of the theory of psychoanalytic knowledge derived from the analysis of children in teaching; secondly, baby and child observation; and thirdly, attendance at lectures and clinical seminars on child analysis irrespective of whether the candidate is treating children himself. 171

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One would hope, of course, that those experiences would be sufficiently alive and interesting to stimulate candidates to take a child training, and I was very glad to hear Dr Gammill report that it was while he was in training for adult analysis that his attendance at child analysis seminars made him undertake a child training. I would like to make one last point. Many people may find that what I call the minimal requirements are already far too ambitious. For instance, I have heard it said that some Psychoanalytic Societies in Europe do not have an experienced child analyst to run the child seminars or do not have anyone experienced in this particular kind of baby or child observation. I would like to make here a suggestion: actually like the rest of the paper even this suggestion is not original – it was made to me in a conversation with Dr Gammill, but I think it is very appropriate to bring it here to the European Federation. With travel conditions as they are now, I do not think that any European Society has to be completely educationally deprived in relation to child analysis or any other aspect of training. Students can travel once-weekly or fortnightly to have supervision, and we have that experience in London. Students will travel when they want to learn. When it is a problem of seminars which have to be held regularly, I am sure that teachers will travel if they are asked to.That, of course, requires devotion; it demands devotion from the student who travels, it demands devotion from the teacher who travels; and yet it may take us a little bit back to the times Miss Freud was describing of the pioneers who were devoted: they travelled to learn and they travelled to teach – and it was very much harder to travel then. I would like, therefore, to come back to my minimal requirements as being minimal requirements and to put it forward at this meeting and bring it to the attention of the organisers of the European Federation: that maybe we could all improve our training if we cooperated more and recaptured some of this more devoted, pioneering spirit in which people were willing to displace themselves, to learn or to teach.

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Over the years Segal, more than anyone, has ‘remembered, repeated and worked through’ Klein’s ideas. Betty Joseph has commented that Hanna Segal ‘understood Klein instinctively, not just because she had an analysis with Klein, but something deeper and more intelligent’. The section begins informally with Segal’s remarks in 1987 at the unveiling of a plaque in Pitlochry, Scotland, where Melanie Klein stayed and worked in 1941.This was the place where Klein analysed Richard – the subject of her classic book, Narrative of a Child Analysis. Segal is often asked to write about Melanie Klein and the second piece ‘Klein’ (1996) was written for the Dictionnaire Internationale de la Psychoanalyse. It has been included in this collection to serve as an introduction to Klein for readers not familiar with her work and offers a clear, concise summary for all. The final piece of this section is Segal’s ‘Review of Kristeva’s Le Génie Feminin Tome II – Melanie Klein’ (2000). As sometimes happens when discussing work from a different psychoanalytic tradition, Segal’s response addresses topics not usually covered in her presentations of Klein’s thought and work, including Klein’s view of Bion,Winnicott and Lacan.

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18 The Melanie Klein plaque in Pitlochr y

These remarks were given at the unveiling of a plaque in 1987 to commemorate Melanie Klein’s stay in Pitlochry, Scotland in 1941. It marks the place where Klein analysed Richard – the subject of her classic book, Narrative of a Child Analysis.

I feel extremely honoured to have been asked to unveil this Memorial Plaque for Melanie Klein. I am wearing two hats – one as the Chairman of the Melanie Klein Trust and one as the representative of Mr Moses Laufer, President of the British Psycho-Analytical Society, who is not able to attend. But what I am going to say will come from myself wearing no hat. I shall say a few words personally, first as an analysand, then as a pupil, collaborator and friend of Melanie Klein. It is a great privilege to have known such an innovative, creative and great personality. Besides, in private she was a most delightful, warm and generous person, humorous and with a great sense of fun. Melanie Klein is considered by many and I count myself among those, as the greatest of Freud’s followers. Her contributions to psychoanalysis start with developing a technique for child analysis.That may not sound all that impressive and today it is hard to appreciate what a bold and important step that was. At the time her work met with enormous opposition. Despite all Freud’s discoveries about infantile sexuality and aggression, it was considered almost indecent to talk to children directly about those things. Her boldness was based on her conviction in psychoanalysis and the psychoanalytical method. Paradoxically her conviction was far 175

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greater than some of those who considered themselves very Freudian and were opposed to her work believing it not compatible with Freud’s. It was also based on her deep devotion to the pursuit of truth, without embellishments, placations or compromises. She approached children with the same honesty which should characterise all psychoanalytical work and found that children responded to this approach. Wilfred Bion, much later, said that the mental apparatus, however immature, needs truth the way the infant needs milk.163 Without formulating it like that, it is certainly the principle she always followed. Direct work with children both confirmed Freud’s imaginative reconstructions and opened new vistas.Where Freud discovered the child in the adult, she discovered the infant in the child and in the adult. The analysis of Richard, which she undertook in Pitlochry, has a very special place in Klein’s opus. She writes in a letter to Winnicott: I have started the analysis of a very unusual boy of ten a month ago and keep full notes including my interpretations from this case. It takes one and a half to two hours a day to make these notes, a drag, but well worth it. And well worth while it was. It is the only fully documented day-by-day analysis of a child that she has published.164 The analysis itself helped her to crystallise some of her most trenchant ideas. Material from Richard figures in other papers, in particular on the Oedipus complex.165 It is in Richard’s analysis that she crystallised the relationship between the depressive position and the Oedipus complex in a way which gave a new amplitude and depth to her understanding of the Oedipus complex. Klein, who came to England in 1926, often expressed her gratitude to Great Britain for having given her conditions of work which she did not have in her own country (Austria) nor in Germany. It later

163 Bion, W.R. 1962b. 164 Klein, M. 1961. 165 Klein, M. 1945.

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gave her a place of refuge from Nazism. She also expressed to me her gratitude to Pitlochry, this lovely little town, which provided her with a place of refuge in the turmoil of the war, gave her hospitality, peace of mind and this precious Girl Guides hut in which she could continue her work during one of the most creative phases of her life. In July 1940, soon after arriving to Pitlochry she wrote to Winnicott: Scotland surpasses my expectations.That is saying a lot, since from a very early time in my life I fancied it as beautiful and romantic. I found very good accommodation in a simple and pleasant house in the most lovely position and the people are very nice. I am quite comfortable and do enjoy the rest and the beautiful country in spite of the knowledge – or all the more because of it – that this peaceful time will not last.166 It lasted only till the following July. It wasn’t in Melanie’s temperament to stay in a haven. By July 1941, she was back in London facing the air raids and the battles in the British Psychoanalytical Society. But she talked to me of Pitlochry with pleasure and affection. Few things would have given her greater pleasure than to know that she would be remembered here and honoured by a plaque. I want to thank all the organisations who worked for it and in particular Dr O’Farrell who was the moving spirit of the whole venture. I also want to thank the Commissioner for Girl Guides for making it possible and for the welcome and hospitality in the hut for all of us. It gives me great pleasure to be able to contribute to this occasion by offering on behalf of the Melanie Klein Trust some photographs of Mrs Klein, her toys and Richard’s drawings as a memento which I understand you would like to display in the famous hut.

166 Grosskurth, P. 1986.

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19 Klein 167

Melanie Klein became a member of the Budapest Psychoanalytical Society in 1919. These were exciting times for the development of psychoanalysis. In 1920, Freud introduced the concept of the life and death instincts, revised his ideas about anxiety and guilt, and formulated his structural theory of the mind.This opened new vistas to psychoanalytical theory and practice. Klein started her work with children in Budapest, in the way common at that time, by analysing her own child. She also tried analysing children in their own homes and with their own toys. But very soon she started developing an innovative technique which was at variance with the work of the other pioneers in the field, like Hermione von Hug-Hellmuth and Anna Freud. She realised that in order to be analysed children must be provided with a setting similar to that obtaining in adult analysis. She saw the children regularly, in an appropriately-furnished consulting room, five times a week for 50-minute sessions. She developed a play technique. She recognised that the children’s play symbolically represented their conflicts and phantasies and could be interpreted in a way not dissimilar to interpreting dreams and verbal communications. She provided each child with a box of small toys and play material most suitable for the child to express him- or herself. Unlike the others who considered that children under seven were not analysable, Klein found that with her technique she could analyse very small children, her youngest being two and three-quarters years old. 167 Segal, H. 2002, ‘Klein’, Dictionnaire International de la Psychanalyse.

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While the other analysts in the field used educational methods, early on Klein came to the conclusion that an analytical attitude has to be maintained, that ‘a true analytic situation can be brought about only by analytical means’; and in such a situation, again contrary to the commonly-held belief at the time, children develop a strong transference relationship.This approach led her to the discovery that children, of whatever age, have a complex internal world of phantasy, which often dominates their lives.The rich clinical material which she obtained confirmed in large measure Freud’s reconstruction of childhood development, particularly in relation to sexual and aggressive phantasies; but she mapped it out in great detail in actual child clinical material.This work, however, led to a certain shift in perspective and to a departure from some of Freud’s ideas. For instance, she observed that children develop an oedipal conflict much earlier on than posited by Freud. Her youngest patient, Rita,168 (under three years old) manifested strong oedipal phantasies, with associated fears of having her genitals attacked in retaliation. Melanie Klein observed that as part and parcel of these early oedipal phantasies, the children had a powerful sadistic superego far earlier than described by Freud, who saw the superego as a late outcome and precipitate of the Oedipus complex. According to her, the internal world was inhabited by highly-idealised figures; and by terrifying, monstrous figures which could be traced to a projection of the child’s own Oedipal sadistic phantasies. But not only Oedipal. Klein had discovered terrifying, persecuting figures that could be related to the child’s earliest relation to the breast. Six-year old Erna,169 who had a very long-standing obsessional neurosis, had not only sadistic Oedipal phantasies, but also much earlier cannibalistic ones.This was one of the controversial points in the debate with Anna Freud.Whilst Anna Freud at that time thought the psychoanalyst had to help build the child’s superego, Klein soon came to the conclusion that, much as in the analysis of adults, the aim of the analysis was rather to diminish the severity of the superego. Klein also related the monstrous aspects of the superego less to the external parents than to the projection of the child’s inner sadism. Interestingly, the only positive reference Freud

168 Klein, M. 1932. See list of patients in Index. 169 Klein, M. 1932. See list of patients in Index.

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made to Melanie Klein was in the footnote to Civilization and its Discontents170 where he discusses the problem of the severity of the superego as depending on inner sources. He says: . . . as has rightly been emphasised by Melanie Klein and by other, English writers. From the beginning of her work, Klein concentrated on the child’s anxieties and defences. Among those, projection and introjection seemed to be particularly powerful. These were the most primitive mechanisms, preceding repression. And it is the projection and subsequent re-introjection that accounted for the child’s inner world peopled by ideal and persecutory figures. From very early on, she also paid a great deal of attention to the child’s curiosity about the parents, the content of the maternal body and the sexual relations between the parents.This she considered so important that she called it the epistemophilic instinct,171 an instinctual impulse as powerful as those of love and hatred. She discovered that children in their phantasies wanted to penetrate and explore the maternal body and functions, and that this exploration was filled with anxieties because it was so ambivalent. It was linked with desire, greedy possessiveness, hostile impulses and projections.And she attributed the inhibition of curiosity less to external prohibition and more to inner experience of anxiety and guilt.This anxiety led the child to displace the original curiosity from his mother’s body and parental relationships onto the external world, thus imbuing the world with symbolic meaning. She considered the anxiety, if not excessive, to be the spur to mental development; but that excessive anxiety led to the inhibition of interest in the external world and to symbolic function. She wrote a number of papers discussing the roots of children’s intellectual inhibitions. These discoveries led to some differences with Freud’s views of the development of infantile sexuality. It also led to a certain shift of empha-sis. She considered unconscious phantasy to be a much more fundamental part of the child’s mind than did Freud. Freud

170 Freud, S. 1930. 171 Meaning the drive to explore the world, to satisfy inherent curiosity.

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considered phantasising begins once the reality-principle has been established. In Klein’s view, phantasy exists from the beginning of life and from the beginning it is attached to objects. Susan Isaacs, in The Nature and Function of Phantasy,172 formulated explicitly what was implicit in Klein’s view of phantasy. Klein considered phantasy to be what Freud called ‘the mental correlate of instincts’.173 In the omnipotent mind of the infant, the impulse includes the phantasy of its fulfilment; but since the impact of reality cannot be avoided, there is from the beginning a constant interplay between phantasy and reality-perception, which moulds the infant’s and child’s view of itself and the world.The phantasy is also a defence which, according to Klein and Isaacs, underlies what we see as ‘mechanisms’: detailed phantasies of splitting, taking-in, expelling etc., and experienced concretely and bodily. Phantasy is a way of organising all the objectrelationships and the self, and is a meeting-ground of instincts, objectrelations and defences. Since phantasy is expressed symbolically (as she found in children’s play), this extension of the concept of phantasy is inextricably linked with an extension of the concept of symbolism. Freud discovered symbolism first in hysterical symptoms. Ernest Jones considered it specifically to be a pathological phenomenon, stating that symbolism arises when sublimation is blocked.174 Klein, on the contrary, considered symbolism to be at the root of sublimation and a fundamental part of the ego development. In her paper, ‘The importance of symbol-formation for the development of the ego’,175 which is an account of the first analysis of an autistic child,176 Klein demonstrated how the child’s excessive anxiety about his phantasies, in relation to his mother’s body, led to the complete inhibition of his relation to the external world, which he could not endow with meaning. She became increasingly convinced of the importance of the child’s dependence on its primary object, the breast. She found that at the most primitive level, children have complex phantasies of other 172 173 174 175 176

Isaacs, S. 1948. Freud, S. 1925. Jones, E. 1916. Klein, M. 1930. This is Dick, who Segal refers to in the final paragraph of ‘Psychic structure and psychic change’ in this book (Chapter 7).

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part-objects, such as the penis. It could be said that Freud discovered the child in the adult and Klein the infant in the child and the adult. This was a very controversial point. It has been argued that Klein attributes too many complications to the infant’s immature mind. And yet, it is in those very first years, well before the full-blown, genital Oedipus complex, that certain fundamental processes are developed – like the capacity for reality-testing, symbolisation, speech and rationality. Klein also paid more attention to the infantile aggressive impulses. Whilst in her early work she tried to see the child’s difficulties in terms of repression of the libido, she very soon noticed that it is aggression linked with libidinal impulses that is the source of both anxiety and guilt. Although the concept of the death instinct had been available since 1920, Klein does not refer much to the death instinct in her early papers, but speaks loosely of the infant’s destructive impulses. It is only in the second part of The Psycho-Analysis of Children177 that she speaks of the conflict between the life and death instincts. But in the papers she wrote at the same time, she frequently refers to it, in particular in ‘Criminal tendencies in normal children’.178 The primitive nature of these phantasies and anxieties, the intensity of the anxiety, and the monstrous or excessively idealised figures that inhabited the child’s internal world, led her to revise Freud’s view of childhood neurosis. She saw childhood neurosis not originating in later oedipal conflicts, but as a defensive structure against more primitive infantile anxieties of a psychotic nature. In 1935 and 1940 Klein wrote two papers (‘A contribution to the psychogenesis of manic-depressive states’,179 and ‘Mourning and its relation to manic-depressive states’)180 in which she tried to give a more comprehensive conceptual framework to her discoveries by bringing forward her concept of the depressive position. One could look at her work up until then as the first phase. In 1946, in her paper ‘Notes on some schizoid mechanisms’,181 Klein introduced the 177 178 179 180 181

Klein, M. 1932. Klein, M. 1927. Klein, M. 1934. Klein, M. 1940. Klein, M. 1946.

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concept of the paranoid-schizoid position.This could be seen as the beginning of the third phase of her work which gave a comprehensive theory of mental functioning. I shall present her theory in its final form, rather than pursue further the historical development of her ideas.

The paranoid-schizoid position It was Klein’s view that from birth the infant has a rudimentary ego. This was a conviction arising not only out of her clinical work and observation of infants, but also, in a way not usually recognised, consistent with Freud’s views about the fate of the life and death instinct. Freud assumed that the ‘organism’ deflects the death instinct outwards. It is the ego that, according to Freud, is the seat of anxiety. According to Klein, there is an ego capable of perception from birth, which is able to perceive anxiety and to deploy defences against it. From the start, this ego forms object relationships, since instinct has not only a source but also objects.The infant at birth is exposed to a welter of perceptions from external stimuli and from internal needs, like hunger, impulses and fears.The rudimentary ego is not initially capable of distinguishing between the two. It operates in a primitive way, which Freud described as, ‘This I shall take in; that I shall spit out’. Gradually, the infant emerges from the state of chaos through splitting, projection and idealisation. Under the impact of anxieties, the libidinal ego aims to project outside everything that is bad and to take inside itself everything that is good. Its aim is to hold, keep inside and idealise a phantasised all-giving breast, while projecting outside everything that is bad, including its own impulses, which creates a phantasised bad breast. Hence the term ‘paranoid-schizoid’ that Klein used for describing this phase of development: ‘schizoid’ for splitting and ‘paranoid’ because of the nature of the anxiety. The primordial anxiety in this situation is the fear of disintegration and annihilation; the primary defences create a schizoid-paranoid world. But this in turn exposes the infant to paranoid anxieties: the loss of the ideal state and object through being invaded and possibly annihilated by persecutors. In her 1946 paper, Klein devotes only a few lines to the concept which acquired an increasing importance in her later work.This is the 183

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concept of projective identification. In Freud’s view, projection comes into operation as a mechanism of defence fairly late and he described it only as a projection of impulses or certain characteristics. Melanie Klein’s concept of projective identification is more extensive than that. In projective identification, the infant projects not only impulses or characteristics, but has a phantasy of actually getting rid of parts of the ego, particularly those parts that experience anxiety and locating them in its objects. Arising in the paranoid-schizoid position, projective identification operates throughout life, but takes different forms at different stages of development and it fills a double objective: that of getting rid of unwanted parts of the self and also, by being located in an object, it may achieve other aims, such as taking possession of, controlling, distorting and attacking the object. It is the basis of hallucinations and delusions. It is a concept that has the clearest demonstration in Klein’s view that the phantasy is a concept linking impulses and defences. Projective identification is a mechanism of defence against anxiety, whilst at the same time being a wish-fulfilling phantasy. In the paranoid-schizoid position there is no concept of ambivalence or frustration. Frustration is experienced as a persecution. There is no frustration but a bad internal breast. Good experiences are attached to the ideal breast, with which the infant also identifies, leading to states which used to be seen as primary narcissism. Bad experiences confirm the infant’s view of the bad breast, whilst good experiences reinforce the infant’s confidence, both in the object and in its own loving impulses. The situation of a split between the two is often confused by the operation of envy, which Klein saw as one of the manifestations of the death instinct and which attacks the object of admiration and desire.When envy operates strongly, it is difficult for the infant to maintain an ideal object, because the good experience itself is attacked, which leads to a confused state in which the good and the bad cannot be distinguished. In a good situation, when the confidence in a good object and the infant’s own capacity to love are felt to be stronger than the bad, the frantic need to push the bad out – in order to retain the good – diminishes, and so the bad breast becomes less terrifying. In such a situation, the need to split, project and idealise the good experience diminishes and, together with the infant’s growing capacity for perceiving time, absence and the reality of the object, slow steps towards integration 184

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take place, which eventually lead to a shift to what Klein called the depressive position.

The depressive position Klein defined the depressive position as that point of development at which the infant perceives his mother as a whole object. By a ‘whole object’ Klein means many interconnected things. A whole object is not split into an ideal and a persecutory one. It is the same breast and the same arms, the same eyes that both gratify and can inflict pain. It is not split into parts but becomes whole.The different functions are part of the total function of a whole person.With this is conjoined the awareness of separateness.The real mother can be seen as sometimes good, sometimes bad; present or absent. A process of realitytesting sets in which leads to a differentiation between the phantasy world (which is the infant’s inner reality) and his or her perception of outer reality. This awareness of the mother as a whole object is part-and-parcel of a process in which the infant recognises him- or herself as one person, not an ideal infant, in love with and sometimes confused with, an ideal breast; or a bad infant, hating a bad breast; but the same infant, loving and hating the same mother. Ambivalence becomes the great issue. The infant hates his loved mother and destroys her in his phantasy. This fills him with an experience of terrible loss and guilt.The fear of loss and guilt gradually replaces the dread of being persecuted by a bad object or objects. Klein saw the roots of the persecutory superego in the paranoidschizoid position, and those of a depressive superego giving rise to a feeling of guilt in the depressive position.This situation of extreme despair at having lost a good object, at once loved and hated, gives rise to a powerful set of defences which she called manic defences. The interplay between loving and hating the object are, according to her, the fixation points of manic-depressive illness. Depressive pain includes the importance of a loved and needed object which is not controlled by the self, and the experiences of guilt about phantasies of destroying it. Manic defences are directed against the dependence and guilt by an increase in omnipotence, by denial of need and dependence, as well as by hatred and contempt for the needed objects.This leads to a vicious circle, since in mania the object is destroyed again, 185

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which increases or brings back the depression. Even in non-manic states, however, there is always some regression to the paranoidschizoid defences; a tendency to split again, to project and to idealise. But another new mechanism mobilised by the depressive position is that of reparation. When the infant recognises that his hatred has destroyed the loved and needed object, there is a wish to repair and regain it. It is not strictly speaking a mechanism of defence, since the defence protects one from recognising one’s anxiety and guilt, whilst in reparation there is a sense of inner reality which is not denied but in need of being restored. In a good situation, the return of an absent mother, or her absent goodness, counteracts the infant’s belief in his or her destructive powers and increases his or her belief in the capacity to restore and regain the situations of goodness. Melanie Klein saw reparation as a fundamental part of development, the basis of the capacity to tolerate ambivalence without hopelessness, confidence in one’s own capacities and a basis for symbolisation and sublimation. Klein connected the depressive position with the beginnings of the Oedipus complex.The infant’s perception of the mother as a whole person implies a person with a life of her own and relationships of her own. She is no more an object viewed narcissistically – almost as a function of the infant – but a person with a complete life of her own and primarily a life with the father.Where, in the paranoid-schizoid position, envy plays a prominent role, since it attacks the sources of goodness; in the depressive position Oedipal jealousy and jealousy of a phantasised/ real new baby becomes an increasingly important factor. As the father is also lovable, the ambivalence to both parents comes to the fore and the reparative impulse comes into play. Parental intercourse is restored as an object of love and admiration and the existence of the sexual creative act as the potential for babies is acknowledged.This gives rise to the conflict between love and admiration and the jealousy, envy and hostile impulses it also arouses.The working-through of the depressive position includes the workingthrough of the Oedipus complex.

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The concept of positions The concept of the paranoid-schizoid and the depressive positions became the fulcrum of Kleinian work. It is partly a developmental concept, in that the paranoid-schizoid position is what Abraham called the first oral stage182 and the change to the depressive position begins somewhere around the age of three to four months. But it does not dominate psychic life till much later. The fundamental change gradually occurs in the state of the ego, the object-relationships, the leading anxieties and defences and in reality-testing. In the paranoidschizoid position the object is predominantly a part-object; in the depressive position the ego is integrated and ambivalent and the object is whole. In the paranoid-schizoid position, the leading anxiety is of disintegration and persecution; in the depressive position it is the fear of loss and guilt. In the paranoid-schizoid position, projective identification dominates and distorts perception; in the depressive position, projective identifications are gradually withdrawn, so that a differentiation between external and internal reality is established. Reality-testing of omnipotent phantasy against reality-perception is gradually established. But the full transition between the paranoidschizoid and the depressive position is in fact never fully achieved. Under stress, regression occurs to the paranoid-schizoid level; and therefore Klein views the two positions not only as stages of development but as two modes of functioning; as two ways of structuring the experience of oneself and the world in a fluctuating way.These transitions between the two states of mind are worked through throughout life.They are also the transitions that are also constantly worked through in the analytical process. Klein’s work has been very influential in the development of modern psychoanalysis in a number of different ways. Her discoveries in relation to early psychotic anxieties gave a stimulus to the analysis of psychotics, particularly amongst her analysands, such as myself, Herbert Rosenfeld and, later, Wilfred Bion. We pioneered the technique for analysing psychotics. Many others also based their work on Klein’s teaching and collectively we came to be known as ‘Kleinians’. We developed her work with children and adults, 182 Abraham, K. 1927.

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including psychotic and borderline patients who had hitherto been considered unanalysable. At present, the younger generations of Kleinians have made significant contributions to the understanding of the earliest phases of the Oedipus complex and its effect on forming the mental apparatus, along with the development of thought. But Klein’s influence went beyond the Kleinians: sometimes explicitly and sometimes implicitly, it can be detected in many non-Kleinian analysts.There is general agreement now about the importance of the first two years of life; and with it comes an acknowledgement of the importance of an inner world of phantasies and objects, including part-objects. The concept of the depressive position and of projective identification are known and often used throughout the psychoanalytic world. Her play technique is the basis of much psychotherapeutic work with children. Outside analysis, her work has influenced philosophers and writers on art, as well as group work; and shown applications to the socio-political scene.

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20 Review of Kr isteva’s L e G é n i e F e m i n i n To m e I I – M e l a n i e K l e i n

Julia Kristeva is a practising psychoanalyst, Professor at the Université de Paris VII and author of many acclaimed books. Her trilogy on ‘female genius’ studies the life and work of Hannah Arendt, Melanie Klein and Colette. Segal’s review was written in 2000 for the International Journal of Psychoanalysis.183

Julia Kristeva is a very well-known and fecund writer. She is a psychoanalyst and writes about psychoanalysis, but she is knowledgeable and interested in what one could call all human sciences including philosophy (her main interest I think being in semiology), literature, art and sociology. One could put it that she is interested in the human mind in all its manifestations. One of her particular interests is psychoanalysis in relation to culture – both the culture in which psychoanalysis grows and by which it is inspired, and conversely, the impact psychoanalysis has made on the culture of the 19th and 20th centuries (and the role of women in this process). Melanie Klein184 is the second volume of a three-part series entitled Le Génie Feminin – a title not easy to translate. In her Introduction to the first volume she tries to define genius in its two meanings: one which was developed in the Renaissance and is in common use, which is the genius of an individual – ‘x or y is a genius’.The other meaning is more ancient and more vague. It is the genius of a group

183 Segal, H. 2001a. 184 Kristeva, J. 2000.

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or culture – its pervading inspiration and mythology – and she poses the question which she says she leaves open (though in fact it is clear throughout the book that she actually has a firm conviction about it) of whether there is such a thing as a specifically feminine genius. Kristeva also gives some idea of what she means by a person being a genius. I think, summarising her views, one could put it this way: she thinks that a genius both embodies and expresses the genius of its culture in its second sense and also overcomes it, opening new horizons: . . . Without them and without modern psychoanalysis of psychosis and autism, which are dominated by the work of Klein, we would miss today this imprint which is specific to the modern culture, that is the proximity of madness and the diversity of dealing with it in a way that modulates it. (Vol. I, p. 17) She also attributes to the word genius the particular quality that it is always more than the sum of its parts. Kristeva always paints on a very large canvas. She describes the impact on the culture of Freud’s Copernican Revolution and she places Klein’s own development in relation to her background, her family and the prevailing culture as well as later events like the Second World War.The biography is rather sketchy and maybe too dependent on Grosskurth185 but her main concern is with the development of Klein’s thought. But neither follows a chronological pattern. I think she pursues three main themes. First, she thinks that what characterises Klein’s work is her passionate interest in liberating thought. Secondly, the importance of matricide as prior to patricide. And thirdly, the importance of the concept of the death instinct as an everpresent, powerful, internal force. Kristeva shows that in her very first paper on her first case, Fritz, [p. 62] Klein186 is interested in and concerned by Fritz’s lack of curiosity and she shows how it applies to other early cases. She also draws our attention to the fact that Klein discovered that her little patient’s curiosity was not inhibited by

185 Grosskurth, P. 1986. 186 Klein, M. 1923.

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parental prohibitions but by his inner resistance to knowing what he could know. Similarly, it is one of her very first early cases [Rita187 – p. 77] that one of the first communications of the child was the presence in her mind of a dead mother.And already in the very early cases Klein is aware of destructive forces in the mind. Of course, those three trends are interconnected in Klein’s work and Kristeva’s account of it. It is towards the end of her book [p. 397] where she formulates that it is around the dead, murdered mother, that symbolism and thought develop. But, as I say, the book isn’t linear in that immediately after those first cases there is a more theoretical part in which she describes very fully the development of Klein’s thought. She gives an account of the world of phantasy in the child, including the primitive phantasies about the mother’s body. She has a chapter called ‘The tyrannical super ego’ which Klein relates to the earliest maternal roots and she gives a full account of the paranoid-schizoid and the depressive position and she uses material from later cases. As the book is very rich and does not proceed in a linear fashion I shall select certain themes. The development of symbolism and thought is one of Klein’s main concerns. Kristeva brings out Klein’s view that the beginning of symbolism is related to the child’s earliest relation to mother and her body. She attributes to the infant a curiosity, which she considers important enough to call an epistemophilic instinct, beginning with the need to explore the mother’s breast and her body. But as this exploration is ambivalent and gives rise to both persecutory and depressive fears, the child displaces it to the external world, thus endowing it with symbolic meaning and Klein’s concern is with the inhibitions and pathologies that impede this process. Kristeva examines Klein’s account of the analysis of Dick188 and Klein’s view that excessive aggression leads to the arrest of symbolisation in the boy. Kristeva pursues the development of that thought of Klein’s by post-Kleinians and she shows a rare grasp of their work. Among others, she gives a succinct summary of my views (Segal, 1957), emphasising the distinction I make between concrete symbolic equations and symbols proper.The concrete equations being formed

187 Klein, M. 1932. 188 Klein, M. 1930.

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in the paranoid-schizoid position by projective identification and in the transition ‘ps-d’ evolve into symbols proper which represent but are not equated with the object. A precipitate of the process of mourning. She continues by giving a similarly full account of Bion’s theory of the container and contained.189 Throughout the book she relates Klein’s work to other views – past and present – but in particular to Lacan,Winnicott and Bion.This recurs in various places in the book but I shall try to summarise it. Kristeva shows Klein’s seminal influence on both Lacan and Winnicott.The differences with Lacan are clear. For Lacan, symbolism starts with verbalisation and is introduced by the phallus of the father. For Klein, symbolism starts in the earliest relation to mother.There is a rich symbolic life which is non-verbal, verbalisation being the peak of the development and very crucial, of course, but not primary. As a semiologist (and feminist?), naturally Kristeva is in sympathy with Klein. She is, however, more open to the criticism of Klein in relation to the role of the father. She does not agree with the position taken by some that Klein ignored the role of the father and in fact Kristeva recognises that Klein brings the role of the father in the child’s life much earlier than Freud did (The Primitive Oedipus complex). Kristeva also says that implicit in Klein’s view there is a role for the father in symbol formation in that part of the reparation in the depressive position is not only restoration of the lost breast but the restoration of father as part of the couple. Nevertheless, I think Kristeva is right in saying that Klein does not explicitly speak of the relation of the father in symbol formation. This, however, is not so in the work of the post-Kleinians. In all my recent papers, whether on symbolism or the Oedipus complex, I emphasise the role of the father and even of the part-object penis as crucial. Bion,190 in his description of the mother’s reverie, describes it as a reverie about the baby and the baby’s father.This is in contradiction to Winnicott’s191 description of primary maternal preoccupation which is a total involvement with the baby (to my mind narcissistic). But by and large Bion speaks of the container and contained as a two-

189 Bion, W. 1962b. 190 Bion, W. 1962b. 191 Winnicott, D.W. 1956.

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body relationship. However, Britton192 suggested that it is a threebody relationship and describes mental space as triangular with three apexes, the lines joining the apexes being the relationship between mother and child, that between mother and father and that between the two parents. (Also, Klein and the post-Kleinians have a different view of the difference between the phallus and the penis. For Lacan, the phallus is a phantasy and the penis is reality and the greater power is attributed to the phallus – for instance, the power to initiate symbols. In the Kleinian view, the phallus is a phantasy of an omnipotent narcissistic penis used for showing off, possessing and controlling and in no sense generative.The genital penis even in phantasy is seen quite differently. It is essential in symbol formation in that it protects mother and child from mutual projective identification and provides a space for new babies (thoughts). Birksted-Breen193 has characterised this difference as that between phallus and penis as link. Kristeva gives a less clear distinction between Klein’s views and Winnicott’s. It seems to me that a cardinal difference lies in their views of narcissism. Both Lacan and Winnicott accept Freud’s view of primary narcissism whilst Klein and Bion assume object relationships from the start.This is evident, for instance, in the different use of the terms ‘ego’ and ‘self ’. Winnicott and many others think of the self as un-object related whereas Klein uses the term ‘ego’ pretty much the way Freud uses it as the basic mental endowment and she uses the term ‘self ’ for the totality of the personality, including internal objects. But even the basic ego grows from ego-syntonic identifications (also Freud’s ego is a precipitate of abandoned object cathexes). For instance,Winnicott’s transitional space194 is a space that should not be infringed by any object liberating the true unconnected self in contrast to Bion’s mental space which is a result of internalising the interaction between mother and child. Kristeva’s method of focusing on certain themes has its many good points but in some places, particularly when the writing is very condensed, it is confusing. I found the chapter on sexuality difficult to follow. It was unclear at times what were the writer’s views, what were

192 Britton, R. 1989. 193 Birksted-Breen, D. 1996. 194 Winnicott, D.W. 1953.

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Klein’s views and the views of Klein at different times. For instance, Kristeva speaks of Klein’s views on the phallic phase in the girl – a concept she later abandoned – seeing the phallic organisation as a defensive structure against an oedipal situation. She also does not distinguish clearly between phallus and progenitive potent penis. On the other hand, I was glad to see that she makes a very clear distinction between the combined parents (the super ego, the psychotic) and a parental couple which are at the centre of the depressive position. Some confusion and possible historical inaccuracy occurs in the sub-chapter ‘The peace and war of the ladies’ (p. 333). Kristeva underplays the importance of the men in the Klein group, suggesting that they started leaving Klein while the women travelled abroad to spread the gospel (pp. 338–339). In fact, the first Kleinians to travel were Dr Herbert Rosenfeld and Dr Hans Thorner. She also states that Bion ‘was begged with tears to acknowledge “the boss”’. But by whom and when? She seems to be referring to the time just after the controversial discussions but, in fact, Bion had just registered with Klein as his training analyst and started with her in 1945 by which time the three groups had already been formed. He qualified as an analyst in 1949–50.195 However Kristeva is right about ‘The peace and war of the ladies’ at the time of the controversial discussions. Klein’s main representatives were Joan Riviere, Paula Heimann and Susan Isaacs. However, this is not true of the following generation. The most frequently quoted of Klein’s followers were Rosenfeld, Segal and Bion – often thought of as a trio. In all her historical accounts I cannot understand Kristeva’s complete omission of Herbert Rosenfeld.There is only a short footnote about him, which is amazing considering that Kristeva puts such an emphasis on the revolution produced by the analysis of psychotics – the area in which Rosenfeld was a great pioneer. Much of the post-Kleinian work she quotes is inspired by his teaching and papers, including a fundamental one on destructive narcissism.196 195 Bion was originally in analysis with Rickman (from 1937) but this was interrupted by the war. On his return he was offered Winnicott as his training analyst but he chose Klein. (Source: Archives of the British Psychoanalytic Society and some personal knowledge.) 196 Rosenfeld, H. 1971.

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Kristeva also touches on the personal links that Klein had with Bion, Winnicott and Lacan and the coolness which she showed towards them. She describes more fully the relationship with Lacan. Naturally, she has had more experience of Lacan as a person than of Bion and Winnicott. She describes the debt that he owed to Klein and ascribes much of the hostility he had towards her to Lacan’s envy (the phallic man’s envy of the woman). However, in Klein’s relationship with all three, Kristeva underestimates the importance for her of clinical issues.What Klein found interesting in Lacan’s work is what Richard Wollheim197 called ‘The cabinet of Dr Lacan’. Klein considered Lacan’s clinical practice to be a gross perversion of psychoanalysis, damaging both to the patient and to the reputation of psychoanalysis. She believed that however interesting a theory might be philosophically, she could not consider it seriously as a psychoanalytic theory if it was not based on sound clinical practice. Partly, the same applies to Winnicott where Klein’s main objection was also to his clinical practice, particularly his employment of active techniques which were anathema to her. She often quoted Freud’s opinion on Ferenczi: ‘The first generation holds hands – the second generation takes patients to bed’. But her personal relationship with Winnicott was quite different to that with Lacan. Lacan, in a personal way, meant very little to her whilst with Winnicott there was a rather tragic and long involvement. Her coolness to him was not primarily related, as Kristeva suggests, to her thwarted wish to supervise her son Eric’s analysis. She was angry at the time but with a better understanding she accepted it. But she always felt guilty towards Winnicott about Eric’s analysis and that is why she never criticised him in public, however strongly she felt about his technique.When Winnicott first came to London he asked Klein to take him into analysis. She told him that there were quite a few people in London who would analyse him but her own son needed analysis and there was no child analyst in London she could trust. So, instead of analysing Winnicott, Klein persuaded him to take on Eric. This is a decision Klein always regretted and subsequently felt guilty about – towards Winnicott personally because he felt so rejected and reacted so badly to the rejection – and also towards psychoanalysis since she felt that his

197 Wollheim, R. 1979.

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activities were quite a threat to analytic development in England. Both were aware of that situation which remained still vivid to the end of Klein’s life. In her last years, she agreed to Winnicott’s request to take his wife into analysis ‘as a compensation for her original rejection of him’.198 The situation with Bion was very different and it is a serious error to put him in the same basket as Lacan and Winnicott, which Kristeva does throughout the book.To begin with, he was extremely punctilious about the psychoanalytic setting and method. In fact, more strict than Klein herself. For instance, he would not change session times for his patients or himself for whatever reason. For him a session was a session and that was it. Either you had it or it was cancelled. Secondly, his psychoanalytic understanding is object related. The container and the contained as the basis of the mental apparatus are not objectless and he repeatedly stated that it is conjoined with the ‘ps-d’ transition. Furthermore, the personal relationship between Bion and Klein was very different from the other two. Certainly, there was no coolness on her part. She was puzzled and not altogether in agreement with his later theories but she also respected his work, did not in any way hamper it and was personally very fond of him. Up to Klein’s death he regularly attended a small seminar of her closest collaborators and friends and his advice was often followed. (It was Bion’s suggestion, which the rest of us accepted, to distance Paula Heimann from the Melanie Klein Trust.) After Melanie Klein’s death he became an excellent and inspiring Chairman of the Melanie Klein Trust, continuing as Chairman until his move to Los Angeles.199 It is significant that virtually all post-Kleinians now refer to Bion’s work and he is accepted as the next important innovator after Klein. A Freud-Klein-Bion model of the mind is now the basic tool of contemporary Kleinian analysts. On the other hand, Kristeva is very good and very clear about the relation between Kleinian developments and sociology. She again uses a broad canvas. Klein’s work happened in the context of Nazism, the Second World War and, later, the nuclear threat. As Freud formulated 198 Private conversation with Segal and observation by Segal of both Klein and Winnicott over a long period. 199 Still the trio! Bion-Rosenfeld-Segal were invited by a group of analysts keen to learn Klein. Bion was the one who accepted the invitation.

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his death instinct theory soon after the First World War, so Klein must have been influenced by the social disruption around her. But at the same time it was her work on the death instinct and the defences against it in the paranoid-schizoid and the depressive position which gives a necessary insight into the understanding of the destructiveness in public behaviour and the way it is being managed. I think it is the place where Bion’s contribution200 was also essential to our understanding of why groups tend to be more pathological than individuals. Individuals project what they cannot manage themselves into the group. It is one of the functions of the group to contain and deal with the uncontrollable and unmanageable. If the group is controlled by rather than integrating the destructive and self-destructive forces, it acts on a psychotic premise. Kristeva is well read in Kleinian and post-Kleinian literature in this area, speaking of Money-Kyrle and later writers such as Margaret and Michael Rustin and F. Arfort in the States. I slightly regret her omission of F. Fornari201 and his classical insight that wars are often the product of a failed mourning about previous wars and the more recent work of PPNW202 and IPANW.203 At the end of the book Kristeva comes back to the problem of female genius. She puts forward the thesis that women are naturally more inclined to turn inwards and explore the internal world which is also often identified with the internal mother’s body.Women are closer to the world of non-verbal communication and symbolisation and more inclined to explore the depths and Kristeva sees a shift in the culture to those more feminine values – the return of the longrepressed womanliness. I agree with her about this shift and linking it with femininity. On the other hand, it does sound as though women were more successful in the ‘ps-d’ transition than men and I am doubtful about it. Nonetheless, one could consider that there are

200 Bion, W.R. 1961. 201 Fornari, F. 1975. 202 PPNW – Psychoanalysts for the Prevention of Nuclear War. Founded in 1983 by Dr Segal together with Dr Mo Laufer. It functioned both as a political pressure group within the British Psycho-Analytical Society, and as a forum for the study of nuclear war and its prevention by psychoanalysts and others. 203 IPANW – International Psychoanalysts against Nuclear War. This organisation was founded in 1985.

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certain values which are in one’s mind associated with femininity and others with masculinity, but which are present in fact in both sexes. And in a way we come back to the parental couple, as it is the cooperation between what could be called masculine or feminine that is necessary for a full creative personality. Some of my disagreements, doubts or criticism apart, this is a remarkable book – original, on the whole well-documented – and thought-stimulating. It is of value to psychoanalysts, philosophers, art critics and historians and all those interested in the functioning of the human mind. In her Introduction to Melanie Klein Kristeva says,‘[As] dissidents in relation to the home background and professional establishment, incurring hostility from clans devoted to normative views, they were capable of fighting with no holds barred to develop and defend their original ideas, Arendt and Klein are not submissive and their genius lies in that they took the risk to think.’ (p.25) Julia Kristeva, in her own way, shows a similar courage in presenting Klein’s work to what may be quite a hostile reception in some quarters which may be important to the author. I for one feel very grateful that she had the courage to do so.

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Segal on Bion

After their respective analyses with Klein had ended, Segal and Bion met regularly at a small seminar held by Klein and composed of Hanna Segal, Wilfred Bion, Betty Joseph and Elliot Jacques. The dialogue between Segal and Bion continued over the years. Not infrequently they came to similar ideas around the same time. In 1956, for example, Bion independently understood the general applicability of the phenomena Segal described in her paper ‘Depression in the schizophrenic’ (1956) and conceptualised it in his theory of ‘bizarre objects’. In 1962, Segal describes what she calls ‘the repressive barrier’204 and in the same year Bion speaks of the ‘contact barrier’.205 Both are referring to a dynamic layer between unconscious and conscious in which symbol formation/alpha function occurs. The closeness of their thought in these years can also be seen in the first piece of this section: ‘The significance of psychic pain in the mental equilibrium’ (1976). Whilst not directly ‘on Bion’ Segal refers to Bion’s differentiation between having a pain and suffering a pain and uses this differentiation in her own clarification of the difference between psychic suffering in the depressive position and the ‘just pain’ of the paranoid schizoid position – experienced in a concrete physical way. The section also includes two presentations to conferences, previously only presented in the Bulletin of the British Society, which are

204 Segal, H. (1962, 1986) 205 Bion, W. (1962b)

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published here for the first time. The first, ‘Bion’s clinical contributions 1950–1965’ (1980), focuses on Bion’s exploration of the pathology of the paranoid schizoid position and his model of the development of the mental apparatus. The second presentation, ‘Introduction to Bion’ (1998), discusses Bion’s formulation on the nature of thoughts and thinking, along with his sources in the work of Freud and Klein and his model of the mind – highlighting his concepts of the contact barrier and beta screen.The paper includes some criticism of his later views, in particular his idea of a ‘thought without a thinker’. We have also included a dictionary entry, ‘Bion’s alpha function and alpha elements’ (1996). In conjunction with the dictionary entry on ‘Symbolic equation and symbols’ this allows comparison to be made between Segal’s concept of symbolisation and Bion’s concept of alpha function. Both Segal and Bion are addressing the issue of how repressed or raw material comes to be the stuff of psychic life. On the whole Segal differentiates Bion’s ‘beta elements’ from her own concept of ‘symbolic equations’. She understands beta elements to be more primitive and fragmented. In her discussions of these matters symbolic equation is generally represented as an early stage in the digestion of raw beta elements to form alpha elements. She sees a close relation between Bion’s concept of alpha function and her own understanding of symbolic function.

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21 The significance of psychic pain in the mental equilibr ium 206

This letter was sent to John Klauber for a scientific meeting Segal could not attend in person. The meeting on ‘The significance of psychic pain in the mental equilibrium’ was held on 15 October 1975 to honour the memory of the Freudian psychoanalyst, Walter Joffe.

Dear Dr Klauber, As you have asked me to contribute some thoughts to the discussion I’m putting down three points which were the basis of my paper. 1. To my great surprise when I started thinking seriously about the concept of ‘psychic pain’ I found it elusive and unsatisfactory.What is psychic pain? Frustration, jealousy, envy, greed, guilt, persecution, depression . . . any unpleasant mental state involving pain. Does it derive from the ‘pleasure-pain’ principle with its biological roots? Does it derive rather, to be more correct, from the pleasureunpleasure principle? 2. I think often when we speak of psychic pain, we mean psychic suffering. Bion remarks somewhere that there is a difference between having a pain and suffering a pain. Psychic suffering can only appear with the establishment of psychic reality – with a differentiation between external and psychic and also the physical 206 The Bulletin of the British Psychoanalytical Society, 1976, Number 4.

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and the psychic. And it is suffering rather than having the pain because it involves an active willingness to accept psychic reality and the pain therein. It belongs to the depressive position – or, if you wish, to differentiation and individuation. 3. Prior to that I think one cannot think of psychic pain; it is just pain with its physical as well as psychological experience. A state of persecution for instance is never pure psychic pain – it’s experienced basically in a concrete physical way. I have not been able to elaborate these points but hope you may find them useful in the discussion. Hanna Segal

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22 Bion’s clinical contr ibutions 1950–1965

This paper was given at a Memorial Meeting for Dr Wilfred Bion in commemoration of his death in 1979 and printed in the Bulletin of the British Psychoanalytical Society, 1980.207

A combination of detailed, precise clinical observation and work and a broad sweep of general ideas and conclusions based on this work is a rare combination and a mark of a truly great and creative psycho-analyst.This combination of rare qualities was characteristic of Wilfred Bion from the very beginning. His membership paper ‘The imaginary twin’208 offers at least two original ideas which proved seminal – the idea of the breast as the infant’s first imaginary twin through projective identification; and the particular link between the ocular development and the Oedipus complex.This was the germ of what became so important in Bion’s work – the crucial role of curiosity in the Oedipus complex and indeed the whole development of the mental apparatus. That first paper was followed by seven brilliant papers between 1950 and 1962, followed in turn by three slim, but intensely-concentrated volumes published between 1963 and 1965 – Learning from Experience,209 The Elements of Psycho-analysis,210 and Transformations,211 207 208 209 210 211

The Bulletin of the British Psychoanalytical Society, 1976, Number 4. Bion, W.R. 1967a. Bion, W.R. 1962b. Bion, W.R. 1963. Bion, W.R. 1965.

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as well as Second Thoughts,212 a collection of his papers with a later commentary. I would call this Bion’s first or English phase. Those first fifteen years produced a great wealth of original thought and contained, I believe, the germ of all his later ideas. I shall take a very subjective line and follow one particular trend of thought, which is the one that personally affected me most deeply and had most influence on my own work. In his papers based mostly on the analysis of psychotics, Bion has explored in great depth and with great precision the interplay between psychotic and non-psychotic modes of functioning.This led him particularly to the exploration of the pathology of the paranoidschizoid position. It was largely unknown territory when he started work. In her ‘Notes on some schizoid mechanisms’,213 Melanie Klein speaks of excessive anxiety, excessive projective identification etc. but gives no precise indication about pathological features. Bion explored the differences between the normal and abnormal development in the paranoid-schizoid position, in particular, the differences in the normal and pathological use of projective identification. In his papers, ‘Development of schizophrenic thought’214 and ‘Differentiation of the psychotic from the non-psychotic personalities’,215 he gives an account of pathological projective identification.This is when in the psychotic personality the intolerance and hatred of reality is so intense that the patient splits up a part of his ego responsible for the hated perceptions.The perceptual apparatus splits it into minute fragments, which the patient projects with great violence into the object, splitting it in turn.These fragments of the object, encapsulating a fragment of the ego imbued with hatred, become what Bion calls ‘bizarre objects’. What should be the ‘furniture of dreams’216 becomes concrete, bizarre objects surrounding a weakened and impoverished ego. In the papers ‘On arrogance’217 and ‘Attacks on linking’,218 he explores the same area from a slightly different angle. He notes that it

212 213 214 215 216 217 218

Bion, W.R. 1967a. Klein, M. 1946. Bion, W.R. 1956. Bion, W.R. 1957. Bion, W.R. 1957. Bion, W.R. 1958. Bion, W.R. 1959.

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is characteristic of the psychotic personality that links between objects are intolerable and are attacked and destroyed. The primitive link between the baby and the object is the nipple. This is destroyed in phantasy, leaving the patient without a link to his object.This absence of links in turn makes him all the more envious and attacking of the sexual link between the parents, the penis.The attacks on linking are not only coming from the patient’s ego, but also and at the first approach, predominantly from an internal object – a superego which seems intolerant of any links; the attack is directed against any emotional ties and any search for knowledge. In those papers, Bion concludes that such a situation results when, for reasons internal or external, the infant has been denied the normal deployment of projective identification. Bion notes that his psychotic patients, intent on projecting feelings or perceptions into him, the analyst, experienced the analyst’s insistence on verbal communication as a mutilating attack on their own projective method of communication. He concludes that the first link made by the child with the breast is by means of projecting into the breast unbearable experiences and exploring his own experience in this projected form. If this projection is blocked by the mother’s non-receptive reaction, the infant experiences the object (the mother) as forbidding and destroying of all links, including the epistemophilic one.This failure of normal projective identification leads to an increase of omnipotent and pathological forms of projective identification – hallmarks of psychosis. Arising out of those explorations and considerations, Bion derived a model for the development of mental apparatus. He argues the need for a distinction between thoughts, and the apparatus which develops to cope with them. This he provisionally calls ‘thinking’. He deals separately with the appearance of thought and the mental apparatus for thinking. In the paper, ‘The theory of thinking’,219 he relates the development of a thought or conception to the matching of a preconception with a realisation: The pre-conception (the inborn expectation of a breast) when the infant is brought into contact with the breast itself, mates with awareness of the realisation and is synchronous with the

219 Bion, W.R. 1962a.

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development of a conception. Conceptions therefore will be expected to be constantly conjoined with an emotional experience of satisfaction . . . The development of thought [on the other hand] is the mating of a pre-conception with a frustration.This mating is experienced as a ‘no-breast’ or absent breast inside. Such a ‘no-breast’ is originally experienced as a bad object and is expelled in omnipotent phantasy, but if the infant has sufficient tolerance of frustration and does not expel this bad object precipitously, he can gradually recognise that what he suffers from is the absence of the good breast and that the bad thing inside him is a product of his own mind. In Bion’s words, the baby comes to the conclusion: ‘No breast; therefore a thought.’ ‘The crux lies in the decision between modification or evasion of frustration’ – Freud’s two principles of mental functioning – demonstrated by Bion in actual, clinical experience with patients. For thoughts to be contained, dealt with, and to become thinking, there must be a mental apparatus capable of containing and using them.This mental apparatus develops out of the interplay of projection and introjection between the infant and the breast. Here Bion elaborates and extends Klein’s concept of normal projective identification. He considers it to be not only an omnipotent phantasy in the infant’s mind, but also the infant’s first method of communication. In Elements of Psycho-Analysis,220 he describes it thus: The infant suffering pangs of hunger and fear that it is dying, wracked by guilt and anxiety, and impelled by greed, messes itself and cries. The mother picks it up, feeds it and comforts it, and eventually the infant sleeps. Reforming the model to represent the feelings of the infant we have the following version: the infant, filled with painful lumps of faeces, guilt, fears of impending death, chunks of greed, meanness and urine, evacuates these bad objects into the breast that is not there.As it does so the good object turns the no-breast (mouth) into a breast, the faeces and urine into milk, the fears of impending death and anxiety into vitality and confidence, the greed and meanness into feelings of love and generosity

220 Bion, W.R. 1963.

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and the infant sucks its bad property, now translated into goodness, back again. Stated in more theoretical terms, Bion postulates that the most primitive experience is governed by beta elements.‘They are the raw element of sensuous and emotional experience in which psychic and physical are indistinguishable.They lend themselves only to projective identification.’221 Those elements are projected into the breast. The breast transforms them into alpha elements. Alpha elements have psychic meaning. They can be stored, repressed, elaborated further, symbolised. They are the elements of dream thought – phantasy. It is the mother’s response to the infant’s projection which gives sense and meaning to the infant’s experience. If the maternal response is adequate the infant can re-introject the breast as a container capable of performing alpha function, the function of converting beta into alpha elements. This model of the conjunction of the container and the contained has very far-reaching implications. It provides the basic model for the development of thought for the perception of relationships, including the oedipal one, for transference and counter-transference interplay. It provides the basis for a differentiation between the psychotic and non-psychotic functioning.The relationship between the container and the contained can be symbiotic, providing a basis of fruitful relationships and learning from experience, or it can be experienced as mutually destructive. When things go wrong in this basic formation of the relationship between the container and the contained, the very basis of the psychic apparatus is interfered with. Instead of the mutually-fruitful interplay, the experience is of mutual destruction, emptying and denuding. Relationships are perceived as mutually destructive, nameless dread replaces meaningful anxiety, bizarre objects appear instead of thought, emotional links are annihilated, omniscience replaces search for truth and hallucination replaces perception. A psychotic mode of functioning is established.The relationship between the container and the contained is affected by both environmental and intrinsic factors. On the environmental side Bion describes the state of mind of a receptive 221 Bion, W.R. 1963.

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mother as a state of reverie – a state of mind making her particularly capable of containing the infant’s projective identification.A mother’s failure in that state of mind is experienced as mutilating the infant’s mode of communication. On the infant’s side the decisive factors are its capacity to tolerate frustration and the intensity of envy. Closely linked with Bion’s research into the relationship of the container and the contained is the concept of the basic emotional links between objects, which he defines as L, H and K – love, hatred and knowledge. In Learning from Experience,222 he explores in particular the K link. Melanie Klein, in her early work, paid great attention to what she then called the epistemophilic instinct.223 In her later work, it didn’t seem to play such a role. It became very important in Bion’s work. K is a link of particular significance in psychoanalysis, which is an exploration of psychic reality – the getting to know is the essential task. When the relation between the container and the contained is of a negative nature, this K link becomes a minus K.The mental apparatus is orientated not to acquiring K, but to destroying it – a hatred of psychic reality becomes a leading feature of the personality. In Transformations224 he differentiates K from what he calls O, the unknown psychic experience and explores the transformations of both and the relationship between them. All this to someone unacquainted with Bion’s work may seem abstract and theoretical. But for anyone familiar with his work and dealing with very disturbed patients, his formulations are of enormous clinical importance, applicable not only to psychotic patients, but to all analysands since as we now know we all contain psychotic parts which have to be dealt with in psychoanalysis. Throughout his work, more and more explicitly, Bion draws our attention to the fact that psychoanalysis is concerned with psychic realities – they are the elements of psychoanalysis – and the analyst’s job is to detect them. He often quotes Freud’s definition of the ego as a perceptual apparatus for detecting psychic qualities. Bion, increasingly, turned his attention to the functioning of the analyst’s mind and

222 Bion, W.R. 1962b. 223 Epistemophilic instinct – a drive to explore the world, to satisfy inherent curiosity. 224 Bion, W.R. 1965.

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the optimum conditions for the experiencing of psychic events and qualities. He expounded his view particularly in the paper ‘Notes on memory and desire’.225 Keats’ notion of negative capability226 is very often quoted now in the British Psychoanalytical Society. I wonder how many people remember that Wilfred Bion was the first to draw our attention to that quotation when he was describing the analyst’s optimal state of mind. In Elements of Psycho-Analysis,227 he suggests that the state of mind of the analyst should be a constant oscillation between a normal paranoid-schizoid position which he describes as a state of ‘patience’, and that of the depressive position, in which elements cohere and give a state which he calls ‘security’. The other dimension to which he turned his investigation was to the theoretical aspects of psychoanalysis, in an attempt to develop it into a more generalised abstract system in terms of functions, factors and elements.The grid is an attempt at categorising levels of mental functioning. But time doesn’t allow me to go into that aspect of his work. I have recently come across Kant saying about Hume: ‘He interrupted my dogmatic slumber’.228 We can certainly say the same about Wilfred Bion. He wouldn’t allow us any dogmatic slumbers. Nor did he allow himself any. In Second Thoughts229 he gives a commentary on his early papers. He states that later thoughts are not necessarily better.They may be looking at problems from a different angle – he would call it a different vortex. Nevertheless, his later view of his own work is detached and often quite critical. I asked him once in Los Angeles what he now thought of a statement of his which had impressed me some years before: ‘Psychoanalysis aims to produce that change in the mental apparatus which enables it to learn by experience.’ He smiled and said: ‘You know, it is rather like catching a tiger and saying “nice pussy cat”.’ In this one sentence he conveyed to me that he did not let himself be lulled to slumbers even by his own earlier work and his great, maybe increasing, awe of the unconscious. 225 Bion, W.R. 1967b. 226 Keats, J. 1817. ‘Negative capability – that is when man is capable of being in uncertainties, mysteries, doubts without any irritable reaching after fact and reason.’ 227 Bion, W.R. 1963. 228 Kant, I. 1783. See paragraph 14. 229 Bion, W.R. 1967a.

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One must not mistake tigers for pussy cats and I hope that in saying just a few things about his early work, in a very compressed form, I did not present Bion himself as tame.That he never was.

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23 Introduction to Bion

This 1998 paper was given to a British Psychoanalytical Society conference in commemoration of Bion’s birth in 1897.230

Coming into contact with Wilfred Bion for however short a time is an unforgettable experience. I met him first at a seminar when he was a candidate and I a newly qualified Associate Member. It was a joint seminar between candidates and new Associates, to discuss criteria for offering patients a Clinic vacancy. It seemed to me then that Wilfred dominated the group, both physically and mentally – a tall, broad, bald-headed man with a remarkable presence. He said very little, but I still remember what he said (and that was a very long time ago). He suggested that the best criterion is the patient’s capacity to maintain a relationship whilst under stress. Later, I was often struck by the conciseness and power of some of his formulations. For instance, his saying, ‘No breast, therefore a thought’.231 In a way, what he was saying was not all that new. For instance, in the ‘Formulations on the two principles of mental functioning’,232 Freud said: It was only the non-occurrence of the expected satisfaction, the disappointment experienced, that led to the abandonment of this

230 The Bulletin of the British Psychoanalytical Society 1998, Number 4. 231 Bion, W.R. 1962a. 232 Freud, S. 1911a.

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attempt at satisfaction by means of hallucination. Instead of it, the psychical apparatus had to decide to form a conception of the real circumstances in the external world and to endeavour to make a real alteration in them.A new principle of mental functioning was thus introduced . . . The recognition of the separateness of the breast and mother from the self and the recognition of the absence of the object, are essential factors in Klein’s concept of the depressive position. In my work on symbol-formation, I relate the capacity for symbolisation to the same factor: the recognition of an absence. But Bion puts it into a nutshell – an unforgettable formulation – and in doing that also adds an important element. His formulation emphasises what is implicit in psychoanalytical thinking, but never clearly stated, namely that thought and thinking are necessarily self-conscious, a Cartesian ‘I think, therefore I am’ (One could almost reverse this:‘I am, therefore I think).The person must be aware, consciously or unconsciously, that thoughts are his thoughts, not to be confused with independent things.When a thought is not self-conscious, at its worst it becomes a hallucinated voice, a foreign body in one’s mind. Curiously, much, much later in his development, Bion stated that there are thoughts without a thinker.To my mind this is irreconcilable with ‘No breast, therefore a thought’. And I think that here we part company. Bion’s first statement is to my mind a most fruitful abstraction and conceptualisation from actual clinical experience, which makes it impossible to think of a thought without the thinker.Thinking and thoughts are a function and product of one’s own personality. ‘Thoughts without thinker’233 seems to be more like a rather mystical kind of philosophy. Of course, there are ideas in the air, often formulated by many people in different ways, sometimes formulated only by a great thinker like Freud conceptualising the unconscious. But those ideas in the air still arise out of people thinking. At some point, it was suggested that I call this introduction ‘Bion in Context’, but this title, though tempting, is far too ambitious. I would have to cover a very broad intellectual background. It would have to include, for example, Plato, Kant, and, for better or worse,

233 Bion, W.R. 1997.

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Wittgenstein and of course all the great analysts who preceded Bion like Freud, Klein, Abraham. Not only them, but his contemporaries too. ‘Bion in Context’ is at least a paper, possibly a book, which remains to be written. I shall confine myself to discussing some of Bion’s concepts which seem to me central to his thinking. Bion did not spring out like Athena from Zeus’s head. Like most of us, he had two parents. His two analytic parents were pretty formidable – Freud and Klein.234 It is my view that two basic concepts were always at the back of his mind. One was Freud’s ‘Formulations on the two principles of mental functioning’,235 as expanded in the paper of that title, to which Bion repeatedly refers and which is the basis of his ‘Theory of thinking’.236 In his paper, Freud considers how the gap in satisfaction is first filled by hallucination and later by thought. Bion repeatedly comes back to the question,‘How does the infant achieve this step between dealing with his needs by hallucination or by thought?’ – and examines it in the light of his clinical material. He says that from the moment of conception, at every turn, the infant has to make a choice between avoiding frustration and dealing with it. It may sound a ponderous way of describing a tiny infant’s mind, yet what Bion is concerned with is the central issue of the step we take from psychosis to neurosis. The second conceptualisation that was never far from Bion’s mind is that of Melanie Klein’s paranoid-schizoid and depressive positions and the shifts between them.This too relates to the transition between psychotic and non-psychotic functioning. In Klein’s description, the gap between desire and satisfaction, described by Freud, is filled by the phantasy of the need-satisfying object.The major developmental step is the differentiation between the internal phantasy world and the reality of one’s dependence on an object. A crucial role in this transition is played by projective identification. In pathological projective identification, the external reality of the object is distorted and denied, thus creating a hallucinatory or deluded world.The with-drawal of projections initiates the depressive position and reinforces the reality principle. Much of Bion’s work is concerned with the 234 This is not to imply Bion was analysed by Freud although he was analysed by Klein. 235 Freud, S. 1911a. 236 Bion, W.R. 1962a.

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pathology of the paranoid-schizoid position and the pathological factors which will impede this development; his major thrust, I think, is in a detailed and comprehensive study of the normality and pathology of projective identification. In one of his first papers on the subject, ‘Differentiation of the psychotic from the non-psychotic personalities’,237 he describes the pathological form of projective identification in which parts of the ego are not only projected but minutely fragmented; in the projection, the object is equally fragmented giving rise to bizarre objects.These are minute fragments of the object possessed by minute fragments of the projected ego and imbued with great hostility.238 Bion later expanded and generalised this work describing the functioning of normal projective identification and relating it to pathological forms. I am speaking of course of his major work on the Container and the Contained,239 the Alpha function,240 and the Alpha and Beta elements.241 Bion introduces the very new idea that projective identification is not only an omnipotent phantasy in the infant’s mind. It is actually implemented and communicated to the mother (a mother experienced by the infant mainly as a breast).The infant gets rid of all awareness of pain experienced by him very concretely with an omnipotent projection into the mother. According to Bion, the mother experiences the impact of these projections and responds to them with understanding. Bion calls the primitive elements projected the ‘beta elements’ and ‘raw elements of experience’: ‘. . . the infant, filled with painful lumps of faeces, guilt, fears of impending death, chunks of greed, meanness and urine, evacuates these bad objects into the breast that is not there’.242 Mother understands the communication and her understanding converts those concrete elements, giving them psychic meaning. Bion calls this process the mother’s ‘alpha function’.The infant can then not

237 Bion, W.R. 1957. 238 For example, in his 1957 paper, Bion describes how a real object is engulfed by a piece of the personality, e.g. the psychotic patient projects their capacity to see into the radio and then is convinced the radio is spying on them. 239 Bion, W.R. 1963. 240 Bion, W.R. 1963. 241 Bion, W.R. 1963. 242 Bion, W.R. 1963.

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only re-introject his projected parts, now meaningful in a psychic way, but can also introject the maternal breast and its alpha function.This provides the core of meaningful psychic life. Bion calls it ‘mental apparatus’;243 one could also call it the core of the ego. He considers the transformation from beta to alpha as a conjoint phenomenon, together with the transition between the paranoid-schizoid and depressive position. I would add that in this process, the infant’s innate capacity for alpha function plays an important role. This concept of the actual communication by projective identification is new and very central to Bion’s thinking and it brings to the fore much more the role of the mother in this process.Whereas in previous Kleinian literature it was always emphasised that the mother’s response and handling had a fundamental role in a child’s development, Bion describes more precisely the dynamic between the internal and the external factors. The process of metamorphosing beta into alpha elements can be impeded by the mother’s inability to perform her function, or by the infant’s envious attacks on this capability – usually a combination of both. His concept of the Container and Contained is widely used by analysts of all orientations but, as is always the case with concepts that become very popular, it is also widely misunderstood. I want to make two points here: one is that Bion’s ‘containment’ is often equated with Winnicott’s ‘holding mother’,244 but in fact the two concepts are very different, since Winnicott did not use the concept of projective identification. In his view, the mother gives space and containment for the infant to develop, as it were, by himself. For Bion, it is a constant interaction between the infant’s projections and the mother’s response. But in the popularisation the infant’s part is often forgotten; the failure is always seen as the mother’s. Bion’s work on K and -K245 also arises out of his extension of projective processes. Klein considered curiosity an extremely important factor in personality. She even called it the epistemophilic instinct. In Bion, it became the ‘K’ (‘knowledge’) link. Klein considered one of the important factors in the infant’s need for projective identification

243 Bion, W.R. 1962a. 244 Winnicott, D.W. 1954–5. 245 Bion, W.R. 1962b.

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was the need to explore the mother’s body. And, like all processes of projective identification, the K link can be interfered with by envious attacks on it. I cannot of course talk about all the ramifications of Bion’s fundamental work, but there is one concept of his which is, to me, particularly valuable and connected with the same train of thought, and that is his concept of ‘contact-barrier’246 and beta screen. Bion re-examines Freud’s idea of normal,‘porous’ repression and ‘excessive repression’247 (much as Klein and her followers before Bion spoke of normal and excessive projective identification). Bion sees repression, not as a line, so to speak, but as a contact-barrier, which he emphasises can be viewed either as a structure or as a function. In the depth of our personality, beta-element functioning is constant, but the alpha function in the personality transforming those elements into alpha is a continuous process.This contact-barrier enables us to be in touch with our deepest unconscious on the one hand, and reality on the other. Bion wrote: I shall now transfer all that I have said about the establishment of conscious and unconscious and a barrier between them to a supposed entity, that I designate a ‘contact-barrier’; Freud used this term to describe the neuro-physiological entity subsequently known as a synapse. In conformity with this my statement that the man has to ‘dream’ a current emotional experience whether it occurs in sleep or in waking life is re-formulated thus: The man’s alpha-function whether in sleeping or waking transforms the sense-impressions related to an emotional experience, into alpha-elements, which cohere as they proliferate to form the contact-barrier. This contact-barrier, thus continuously in process of formation, marks the point of contact and separation between conscious and unconscious elements and originates the distinction between them.The nature of the contact-barrier will depend on the nature of the supply of alpha-elements and on the manner of their relationship to each other.

246 Bion, W.R. 1962b. 247 Freud, S. 1915a.

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But when this is the case there is always some psychic pain involved. Where alpha functioning is interfered with, as a defensive measure against depressive position, the contact-barrier gets transformed into a beta screen composed of beta elements and forming an impenetrable barrier which cuts the subject off from both internal and external realities. I have also studied the question of the meaning of ‘excessive repression’ by suggesting that in normal repression we are symbolically in touch with our internal realities, whilst so-called ‘excessive repression’ is in fact a splitting-off of psychotic content. However, like other concepts of this kind, Bion’s idea of the contact-barrier and beta elements is more comprehensive, more detailed, and dynamic. For instance, he describes how it is enacted in the analytical session, making the patient inaccessible unless its functioning is understood: A beta-screen forms an impenetrable barrier. It is a defence against any meaningful emotional experience. As the beta-screen is composed of beta-elements which lend themselves to projective identification, it also manifests itself in a bombardment directed both against the alpha-functioning of the patient himself and against any external object susceptible to arousing meaningful feelings. In analysis, the patient bombards the analyst with confused fragmentary material imbued with violence and directed against the analyst’s attempt to get in touch with an emotionally-significant experience.248 Bion’s concept of an alpha function and the relation between the container and the contained had a profound influence in clinical work, particularly in our understanding of the interplay between transference and counter-transference.As you may know, before Bion, clinicians, particularly Kleinians, were rather wary of the clinical use of counter-transference, as it was – and unfortunately still often is – open to much abuse. It was this understanding of Bion’s – that beta elements can only be projected, and that this projection of beta elements specifically has an impact on our minds – that helped us to understand that this is the crux of a psychotic transference and 248 Bion, W.R. 1962b.

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counter-transference. In the depths of our mind, we have both to experience and to transform those projections into a communicable experience.That understanding threw a new light on the therapeutic factors in analysis and had a profound influence on our understanding and technique. I have spoken of Bion in the context of his deep roots in the work of Freud and Klein, but he has often enlarged and transformed their concepts. Bion, however, was also a child of his time. Following Klein’s seminal paper,‘Notes on some schizoid mechanisms’,249 there was a particularly creative ambience when a number of younger analysts started exploring the new areas of investigation she had opened up. There was a lot of creative fervour and fruitful interchanges. Mrs O’Shaughnessy’s paper250 is on the superego. Bion was certainly well aware of Herbert Rosenfeld’s251 pioneering paper on the superego of the schizophrenic. Rosenfeld, like Bion, explored the counter-transference in psychotic patients and they undoubtedly influenced one another. I worked on concrete symbolisation;252 Money-Kyrle253 worked on cognitive development etc.These were the ideas in the air. I am not saying this to undermine Bion’s stature. It is the hallmark of a creative mind, such as Bion’s, to have roots in the past and present, but to transcend them and create something new. And the context is not only the past and the present, but also the future.‘Ye shall know them by their fruits’.254

249 250 251 252 253 254

Klein, M. 1946. O’Shaughnessy, E. 1999. Rosenfeld, H. 1947. Segal, H. 1957. Money-Kyrle, R. 1968. Matthew 7:16. The Gospel According to St Matthew (The Sermon on the Mount).

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24 Bion’s alpha function and alpha elements 255

Alpha elements Bion used the term ‘element’ first in Experiences in Groups,256 but only in very general terms. In ‘A theory of thinking’257 Bion describes for the first time (except for an unpublished paper presented at a scientific meeting of the British Psycho-Analytical Society) the use of the concept of ‘alpha-function’ as a working tool in the analysis of disturbances of thought: It seemed convenient to suppose an alpha-function to convert sense data into alpha-elements and thus provide the psyche with the material for dream thoughts and hence the capacity to wake up or go to sleep, to be conscious or unconscious. According to this theory consciousness depends on alpha-function and it is a logical necessity to suppose that such a function exists if we are to assume that the self is able to be conscious of itself in the sense of knowing itself from experience of itself. In this paper he describes how alpha-function converts betaelements (raw sense data) into alpha-elements. He is particularly 255 Segal, H. 1996c ‘Bion’s alpha function and alpha elements’, Dictionnaire International de la Psychanalyse. 256 Bion, W.R. 1961. 257 Bion, W.R. 1962a.

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concerned with the differentiation that is established between the unconscious and the conscious. He considers alpha-elements to be elements necessary for consciousness. By ‘consciousness’ he means specifically self-consciousness, since beta-elements in a sense are also conscious as raw perceptions. When the infant’s consciousness gets invaded to an unbearable extent by beta-elements, the infant is driven to project these outside.When the beta-elements are transformed into alpha-elements, they become consciously apprehended and a differentiation is established between the conscious and the unconscious. In Learning from Experience258 Bion gives the following example at the start of Chapter Seven: If a man has an emotional experience when asleep or awake and is able to convert it into alpha-elements he can either remain unconscious of that emotional experience or become conscious of it.The sleeping man has an emotional experience, converts it into alpha-elements and so becomes capable of dream thoughts.Thus he is free to become conscious (that is wake up) and describe the emotional experience by a narrative usually known as a dream. Similarly, a person having a conversation converts the beta-elements into alpha, and, thus freed of all the most primitive ways of functioning, he can have a rational conversation whilst not losing touch with his unconscious. Alpha-elements form what Bion calls a ‘contactbarrier’ – the part of the mind in which beta-elements are transformed into alpha – and this contact-barrier could be seen as a flexible barrier of repression. Alpha-elements comprise visual images, auditory patterns, olfactory patterns, and are suitable for employment in dream thoughts, unconscious waking, thinking, dream, contact-barrier, memory.259 Alpha-elements are a product of alpha function. Bion develops his thought in a number of later writings, but particularly in Learning from Experience.260 He describes various characteristics of alpha-elements at

258 Bion, W.R. 1962b. 259 Bion, W.R. 1962b, Chapter 10. 260 Bion, W.R. 1962b.

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various times.They can be stored and repressed.They undergo further transformation and abstraction. They are the elements of dream thought, dream, myth, and conscious thought. And they form the contact-barrier between the conscious and the unconscious.

Alpha function Bion’s work on the ‘alpha-function’ is based on Klein’s concept of projective identification. He adds to it another dimension by suggesting that projective identification is not only an omnipotent phantasy in the infant’s mind, but that it is also the infant’s first means of communication. The first published statement about the alpha-function is in his paper ‘A theory of thinking’.261 But there are many forerunners in Bion’s work. For instance, in his paper, ‘On Arrogance’,262 he describes a patient who perceived his analyst as someone who ‘could not stand it’ (the ‘it’ being undefined). Bion concluded that the patient’s means of communication was preverbal and by projective identification of the primitive ‘it’; the patient experienced the analyst’s insistence on verbalisation as an attack on his own means of communication. In a subsequent paper, ‘Attacks on linking’,263 Bion describes the patient who as an infant could not contain his fear of death. He split it off, together with a part of his personality and projected it into the mother. Bion remarks: An understanding mother is able to experience the feeling of dread, that this baby was striving to deal with by projective identification, and yet retain a balanced outlook. By projecting into the mother this feeling of dread, the infant makes the mother experience it and thus communicates to her his own distress.This situation was repeated in analysis. Bion emphasises in this paper that there is a realistic aspect of projective identification which

261 Bion, W.R. 1962a. 262 Bion, W.R. 1957. 263 Bion, W.R. 1959.

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can elicit in the mother the appropriate response.When that response is not forthcoming, the fear of death in the infant is reinforced and cannot be processed. In ‘A theory of thinking’264 Bion forms the hypothesis of an alphafunction exercised by the mother in processing the infant’s projective identification and converting what he calls inchoate sense-data.This includes converting emotional data, which he calls beta-elements, into alpha-elements, which are the material of dream-thoughts and consciousness: It seemed convenient to suppose an alpha-function to convert sense data into alpha-elements and thus provide the psyche with the material for dream thoughts and hence the capacity to wake up or go to sleep, to be conscious or unconscious. According to this theory consciousness depends on alpha-function and it is a logical necessity to suppose that such a function exists if we are to assume that the self is able to be conscious of itself in the sense of knowing itself from experience of itself. Bion deliberately does not give a definition of the alpha-function, as he can only deduce it from its elements. He suggests that it needs to be studied further. He does not give definitions, but describes the process and offers the following as a model:265 . . . the infant filled with painful lumps of faeces, guilt, fears of impending death, chunks of greed, meanness and urine, evacuates these bad objects into the breast that is not there. As it does so the good object turns the no-breast (mouth) into a breast, the faeces and urine into milk, the fears of impending death and anxiety into feelings of love and generosity and the infant sucks its bad property, now translated into goodness, back again. As an abstraction to match this model I propose an apparatus, for dealing with these primitive categories that consists of a container and the contained.The mechanism is implicit in the theory of projective

264 Bion, W.R. 1962a. 265 Bion, W.R. 1963.

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identification in which Melanie Klein formulated her discoveries of infant mentality.266 The concept of alpha-function leads to that of the relationship between container and the contained. The internalisation of that figuration provides the basic apparatus for thought. The mother’s receptivity to the infant’s projective identification is a central factor in this process.This receptivity depends on what Bion calls the mother’s capacity for ‘reverie’267 – a dream-like state, the content of which is her love for the infant and its father. The interference in the alpha-function and the container-contained relationship may lie in the mother’s failure of reverie or in the infant’s excessive omnipotence and envy.The alpha-function is related to, and conjoined with, the passage of the paranoid-schizoid position to the depressive position.

266 Klein, M. 1946, p. 31. 267 Bion, W.R. 1962b, Chapter 12.

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Envy and narcissism

Envy and narcissism are key concepts in Kleinian thought and are addressed in two presentations. The first, ‘Envy and jealousy’, was written in 1969, the second, ‘Narcissism: comments on Ronald Britton’s paper’, in 2000. In the 1969 piece, Segal discusses the nature of envy and goes on to make a link between envy and narcissism, describing them as ‘two sides of the same coin’.Thirty-one years later, as respondent to a paper on narcissism by Ronald Britton, Segal comments on the omission in Britton’s paper of the role of envy in persistent narcissism. She suggests there may be two reasons why the role of envy might be avoided. First that it was over-interpreted in the past and secondly that of all situations, the realisation of primitive envy is the hardest one to bear for patients and analysts.

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25 Envy and jealousy

This is Segal’s contribution to the British Psychoanalytical Society’s 1969 Symposium on Envy and Jealousy. Her comments were made in response to a paper by Walter Joffe. It is unusual to have comments at a symposium on record. Her comments here survived because for a short time under the Presidency of John Klauber, all discussions at British Society Scientific Meetings were recorded.268

Following on Dr Joffe’s appeal that we should talk to one another rather than at one another, I shall only take up a few points directly related to Dr Winnicott’s and Dr Joffe’s contribution: 1. In relation to the environmental factors, nobody would deny the importance of environment. The question is, does environment produce the feeling? If we think, for instance, of oedipal jealousy and its relation to the environment, then certainly the environment has a decisive influence on the form the oedipal jealousy will take; it will modulate it. Nevertheless, we know that the Oedipus complex is inherent in the child’s development and oedipal jealousy cannot be avoided, even when in reality there is no father. In this context I think it may be worthwhile to try and clarify what Mrs Klein meant by ‘constitutional’. It seems to me that she meant two things: a. That envy, like love, hatred or jealousy, is inherent in human nature. She considered it as innate (I am not quite sure what she 268 The Bulletin of the British Psychoanalytical Society, 1969, Number 29 (Part 2).

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means by ‘primary’, since she describes it as a derivative of the death instinct. I think she means primitive.) b. She emphasises that there are constitutional variations, as well as environmental ones. Dr Winnicott considers heredity as external to the infant. I cannot see that his way. I wonder if there is a confusion here between factual and moral statements. Nobody can ‘blame’ the infant for his heredity, any more than he can be blamed for his environment. Nevertheless, it is a fact that the poor chap who has an extra chromosome is constitutionally different from the one who has the normal number of chromosomes, and although no ‘blame’ can attach to him, nevertheless it is a fact that he has a harder task in containing and integrating his aggressivity. 2. I am not impressed by Dr Joffe’s emphasis on ‘organ inferiority’. To take the example he gives of a man with hypospadias,269 I wonder why that man felt so inferior about it while thousands of others can cope adequately with this small malformation.What are the deeper causes of his feelings of inferiority and envy? I had a patient who had deep feelings of inadequacy and tremendous envy of other men because his penis was circumcised. In his case it turned out in the analysis that the real narcissistic wound was sustained at the time of weaning, which was sudden and premature at a time when he felt the nipple as a part of his mouth and felt himself injured by its removal. But even if we take Dr Joffe’s other examples of crippled or ugly unmarried middle-aged women, I still think that feelings attaching to those facts are secondary, however painful they are. In my own experience I have known women who were exceptionally ugly (and in one case quite severely crippled) who were quite happily married. On the other hand I have seen statistics that the highest rate of suicide among women is among exceptionally pretty and attractive women aged between twenty and thirty. I think this exceptional attractiveness is often a psychosomatic expression of a narcissistic (and to my mind, envious) personality.

269 Hypospadias – a relatively common birth defect. It is characterised by an abnormal positioning of the meatus, the opening through which urine passes.

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Unlike Dr Joffe, I do not see envy – the genuine primitive article – as in any way combined with hope. I see it as one of the deepest roots of hopelessness, since it attacks the sources of life. 3. This brings me to the relation between narcissism and envy. I agree with Dr Joffe that there is a link between narcissism and envy. I have often noticed that what non-Kleinian colleagues would describe as a reaction to a narcissistic wound, I would see as envy. To my mind a persistence of narcissism is often an expression of, as well as a defence against, envy. Envy and narcissism can be seen as two sides of the same coin.The infant wishes to see himself as a source of all love and goodness, and the moment his belief is shaken he experiences envy of the object which is felt to contain life and goodness. Leaving aside for the moment the expression ‘at birth’, I would say that envy is experienced the moment a ‘narcissistic wound’ is sustained – if we take the narcissistic wound not as a late phenomenon but as something that may happen with the first cry or the first hunger.

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26 Narcissism: comments on Ronald Br itton’s paper

In 2000 the Melanie Klein Trust organised a conference to celebrate the work of Herbert Rosenfeld. Segal’s comments were made in response to the paper given by Ronald Britton270 at that conference entitled ‘What part does narcissism play in narcissistic disorders?’ Britton summarises the argument of his paper as follows: In summary, what I am suggesting is that narcissistic disorders arise when there is a failure of containment in infancy and childhood, which gives rise to an egodestructive superego. A narcissistic organisation is evolved using narcissistic object relations – internal, external, or both – to evade the hostile superego. This may result in a predominantly libidinal organisation or a predominantly destructive narcissistic organisation. I further suggest that the libidinal, defensive organisation arises when the main factor in the original failure of containment is on the parental side and the destructive organisation when the major factor is an excess of object-hostility in the infant. If we use the word narcissism to denote this urge to annihilate otherness, the answer to the question of what part narcissism plays in narcissistic disorders is that it depends on how destructive they are. If the organisation is predominantly destructive, narcissism appears to play a large part; if it is predominantly libidinal, then infantile trauma appears to play the larger part. In the second of my two cases, Mrs D., one could suggest

270 Ronald Britton is a British Kleinian psychoanalyst and author of Belief and Imagination and Sex, Death, and the Superego.

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Envy and narcissism that it was the narcissism of the parents that played the major part in the patient’s development of a narcissistic disorder.271

Herbert Rosenfeld made a fundamental contribution to problems of narcissism. His 1971 paper272 linked narcissism to the death instinct and described the narcissistic organisation as a narcissistic structure which is both a defence against, and an implementation of, the death instinct and its manifestation in envy.As in all such organisations both libidinal and destructive elements play a role. In his later work,273 Rosenfeld tried to distinguish between what he called ‘libidinal narcissism’ and ‘destructive narcissism’. I think his description of destructive narcissism, a structure based on projective identification with an internal object which dominates the personality (as, for example, in his classic description of the gang) is generally accepted as uncontroversial and has inspired much of our later work. But this is not the case in relation to his description of libidinal narcissism.274 There are some disagreements about the actual interplay of the libidinal and destructive forces in narcissism. In his paper on ‘Narcissism and narcissistic disorders’, Ronald Britton describes Rosenfeld’s view (as expressed by him in many papers) that it is important to distinguish, ‘Between those narcissistic states in which the libidinal aspects predominate and those where destructive aspects predominate’.275 Britton refers to my views saying, ‘For her [Segal] there is only destructive narcissism and libidinal narcissism doesn’t exist’. This is not quite correct. What I state is that I do not believe in a persistent libidinal narcissism, i.e. a libidinal narcissism as part of a persistent narcissistic structure.What I actually mean is this: Klein differentiates between what she calls narcissistic states and what she calls narcissistic object relations, but what she

271 This paper has since been published in Sex, Death and the Superego under the title ‘Narcissism and narcissistic disorders’. 272 Rosenfeld, H. 1971. 273 Rosenfeld, H. 1987. 274 ‘In considering narcissism from the libidinal aspect one can see that the overvaluation of the self plays a central role, based mainly on the idealisation of the self’, Rosenfeld, H. 1971. 275 Rosenfeld, H. 1971.

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actually means, quite clearly, is a narcissistic structure since those object relations are internalised. The narcissistic state is an identification with the original ideal object. This is a temporary state because in non-pathological development the ideal object becomes a good object. If the ideal object is felt as good and strong enough then there is less need to project everything bad outside – projections are gradually withdrawn and the ideal object becomes an ordinary good object. This kind of libidinal tie, therefore, is only a passing phase. Of course, like all infantile states it does not entirely disappear and reappears now and then in our adult life, for instance in states of being in love, which often contain a strong narcissistic element. But if the state of being in love does not evolve into more mature loving then we are in trouble. Britton cites Romeo and Juliet as an example of libidinal narcissism but it ends in self-destruction and death. In fact, in Romeo and Juliet the destructiveness is neatly projected outside into parental superegos but it triumphs all the same.Where Rosenfeld sees libidinal narcissism as a situation in which libido predominates over the destructive instinct, I see that in some cases the death instinct is more powerful and dominates over the life instinct, while in other cases it is less so. It is evident that of the two cases Britton discusses in this paper, the first patient is very much iller. Nearly her whole personality is dominated by her narcissistic organisation. His second case is very much less so. She has a clearly idealised and highly eroticised relation to her twin but the question is why the narcissistic structure or organisation at all? What is kept at bay? She obviously has a much healthier ego and she has a job, husband, family but such libido as is destined to become part of the narcissistic structure impoverishes the rest of her life. Britton refers to John Steiner’s276 concept of the pathological organisation – at basis a narcissistic one.This is a structure defending both against paranoid-schizoid anxiety and depressive anxiety. I think it is of prime importance which of the two predominates. It is quite clear that Britton’s first patient is struggling with most primitive, oral, sadistic and paranoid anxieties. The second patient seems to be defending more against depressive and oedipal anxieties.

276 Steiner, J. 1987.

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Then there is the problem of the superego. Britton quotes Rosenfeld, who argues that at the centre of the narcissistic structure is an envious, destructive superego. Britton says both his patients were struggling against a murderous superego. I question why the object is described as a superego. Do we now call all internal objects superego? In the case of Britton’s first patient, I would think of a persecutory object. I think I call superego only that aspect of the internal object which exercises moral pressure, though its roots as we know, may be in the persecutory and ideal object.And I question the whole idea of being loved by one’s superego. I think of the superego as bad when it is filled with hatred, of course, but I also consider it not a good superego if it is over-loving. I see a good superego being more like a litmus paper – reality sense in the moral sphere – and it should not be part of any power structure. It does not tell you what to do – only what is. It is ego-syntonic because it supports and strengthens the ego’s own capacity to exercise judgements.Also, in some places Britton refers to it being a paternal superego – a third object – but it is clear in his first patient (and he says so) that it is much more primitive anxieties that are in play which invade and distort the oedipal theme. Why is the envious, murderous superego taken almost for granted in these cases? After all, the narcissistic person lives in a hall of mirrors. Isn’t this murderous superego, in part at least, a projection of the patient’s own feelings? In L’s second dream (the first patient) about the horrifying feeding experience, is the monster the object? Or is it a projection of the baby’s own angry and envious mouth? Describing his patient, Peter, in Impasse and Interpretation277 Herbert Rosenfeld speaks of the murderousness of his envy. So what is the narcissistic structure defending against? The object’s murderousness or the subject’s? Confusion. Rosenfeld has emphasised that at the base of it there is a failure of splitting. Britton accepts this view, and so do I – that defences against confusion are paramount. But we do know that a most powerful element in confusion is envy. If you hate a bad object and love a good object you know where you are. But if you hate and project the hate and the envy into the good object, then you are bound to be confused because the better the object is, the quicker it turns into a bad object filled with all the projections. Narcissistic

277 Rosenfeld, H. 1987, pp. 88–90.

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organisation protects us from that confusion. Britton emphasises the role of the failure of containment and also the role played by parental projections.This, of course, is very important. But we must not forget that in some people, maybe what is more important is what is being projected into the container. This takes us to the whole question of the relative importance between external and internal factors. It is significant that the parents of the more ill patient were in fact less awful than the parents of the second patient.Therefore, we can assume that her projections were more violent and disruptive. In fact, her dream of feeding the baby for which she blames her mother could well be her own ferocious, envious attack on the feeding process. All three of us – Rosenfeld, Britton and I – have observed that, within certain limits, the presence of a better environment in a person’s life means a worse prognosis because the emphasis is then on internal factors (while not, of course, ignoring the interplay with the environment). I do not think Rosenfeld would agree but it is my impression that he became more preoccupied with the external traumatic factor than he was with the reality of the patient or child’s part in this process. Looking at the sessions reported by Britton, I have a feeling more attention was paid to the lack of containment and the fear of the bad superego, than to the patient’s projections. While thinking about Britton’s paper, I had a free association. An old joke came to my mind. At a party an old lady overheard a conversation between some young people about sex. She listened attentively then called a young man aside and whispered ‘Doesn’t anybody ever do it the old-fashioned way?’. I suddenly had a picture of myself as this old lady asking shyly,‘Doesn’t anybody ever do it the old fashioned way and interpret straight envy?’ I think this joke has a point. I think there are two reasons for that avoidance. One is that admittedly to begin with we did over-interpret envy – sometimes too often and too soon, not quite realising the power of those interpretations.This, unfortunately, is true of most powerful new concepts and there is a to-and-fro swing. But the other reason is that of all situations, the hardest one to bear for the patient is the realisation of his primitive envy. It is also the most frightening and hardest thing for the analyst to deal with and so we have endless ways of avoiding it.

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The book ends with two interviews: ‘Hanna Segal interviewed by Jacqueline Rose’ (1990) and ‘Hanna Segal interviewed by Dorrit Harazim’ (1998).The interviews were chosen by Segal from the many she has given because of the challenging topics that are covered in them.

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27 Hanna Segal inter viewed by Jacqueline Rose

Hanna Segal was interviewed in 1990 by Jacqueline Rose for the journal Women: A Cultural Review.278

Jacqueline Rose: Could you say something about what first attracted you to psychoanalysis and specifically to the work of Melanie Klein? Hanna Segal: It is very difficult to identify again with one’s adolescent self. I was lucky in that I had access to psychoanalytic literature from when I was very young. I had read everything by Freud that was translated into Polish or French, which wasn’t an awful lot, by the time I was seventeen and I was always fascinated by analysis. A book that influenced me enormously was René Laforgue’s book on Baudelaire.As I grew older I had to reconcile three things I was interested in. One was art and literature; the other was politics – well, politics is a nasty word, I never wanted to be a politician – but social concerns, left-wing politics, prison reform and things like that; and interest in working with people. So psychoanalysis was an answer to my prayers because you could work with people, it gave me an approach to the social problems (I must have read Civilisation and its Discontents279 which I think was one of the translated texts) and it allowed for my interest in art and literature.Actually, analysis

278 Summer 1990, Vol. 1, No. 2, pp. 198–214. 279 Freud, S. 1930.

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for me was a second choice, what I really wanted was to be a novelist – not a poet, not a musician – but a novelist, because writing novels really covers the same area of my interests, but I did not think I had enough talent or inventiveness for that and psychoanalysis was the next best thing. That’s why I went into medicine, with an idea of becoming an analyst, which wasn’t easy because I had no idea how to set about such a thing. I went to our lecturer in neurology, Dr. Bychokuski, who was one of the two psychoanalysts in Poland (he later became a famous American analyst) and asked him how one became an analyst. He said you go to Vienna. I didn’t want to go to Vienna; I consider myself an internationalist but neither Germany nor Russia were very popular in Poland. Then the war found me in Paris. So I rang Laforgue, because I was so impressed by his book, with the same question but he said, ‘Goodbye, goodbye, I am getting evacuated tomorrow’. Finally it was when I was doing medicine in Edinburgh that Dr. Fairbairn set me on the right track. He was extraordinarily helpful. He explained that there was an Institute and that it was in London and then he told me that there were two trends in the Society, one connected with Anna Freud and one with Melanie Klein. I must say, he kept very neutral and didn’t try to influence me. He gave me Anna Freud’s The Ego and the Mechanisms of Defence280 and Melanie Klein’s The Psycho-Analysis of Children.281 Melanie Klein’s book stimulated me enormously with all the vividness of the clinical material, Anna Freud seemed to me very cold and academic, but that was just intuitive.Then Dr. Fairbairn let me borrow his copies of the International Journal of Psychoanalysis and I made up my mind.When I made my choice, it was fortunate in that I had more reading behind me than many people and had started thinking about it all when I was very, very young. I then had to wait in Edinburgh until I got my medical qualification, but I also had no money as I was on a scholarship of £2 per week. I wanted to go into analysis with Fairbairn but his fee was £1 a session so I couldn’t very well do that. But he put me in

280 Freud, A. 1936. 281 Klein, M. 1932.

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touch with Dr. Matthew, an associate member who had been analysed by Mrs. Klein and he took me at a nominal fee for about a year. It was probably his introduction to Mrs. Klein that made her give me a vacancy. By the time I came to London, I had made my choice. Of course I had no idea of the hostilities that had developed by then. Jacqueline Rose: You have said that you had to insist to get analysis with Mrs. Klein. That story always amuses me – that she had no vacancy and she was very expensive, and yet you insisted. Hanna Segal: No, not very expensive, she never was a fee grabber, but I suppose she was charging an average fee, which I then couldn’t pay. She wanted to send me to Paula Heimann, who was a new training analyst. I just dug my heels in and said I would wait until she had a vacancy and she took me on as a clinic patient until I got a decent job. In those days, all psychoanalysts, not only candidates, had to carry one clinic patient. I was a houseman at Paddington Green Hospital earning £10 a month, again not enough to pay a fee, but I very soon got a job as a psychiatrist with the Polish government in exile and I could pay my fees. I think Mrs. Klein at that time was also very keen to have bright young candidates and that must have played a part. Jacqueline Rose: I am very interested in the fact that you came via Warsaw to Paris and then to London. My sense is that some such history is typical of many analysts in the founding moments of analysis in England. Do you think that’s true, and if so, do you think it has had an effect on the development of psychoanalysis in this country? Hanna Segal: It is partly true, but more so of other countries. In fact, in England the pioneers were natives, if you excuse that expression. All the names that come to my mind – Jones, Riviere, Sylvia Paine, John Rickman, Gillespie, Ella Sharpe – they were all from Great Britain. Jones was Welsh, Gillespie was Irish, so there is a mixture of English,Welsh and Irish. It was very much an indigenous group. I think psychoanalysis seemed to fit the Jews but for some peculiar reason also the British. Jacqueline Rose: That is very different from what Lacan used to say – that the inheritance of Victorian culture meant that psychoanalysis had terrible trouble in England. Hanna Segal: Not at all. After all, the International Association was 239

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formed by Ernest Jones. On the immigrant issue – there were one or two classical Freudians who came about the same time as Mrs. Klein. Mrs. Klein came here very early, in 1926, and had a very big influence, but only because things in England were already moving. Jones disagreed with Freud about female sexuality and about the role of aggression.There were already the beginnings of child analysis with people like Nina Searl. Joan Riviere, Freud’s translator, was very enthusiastic about Mrs. Klein from the beginning, as were the Stracheys who were instrumental in bringing her over. So Mrs. Klein absolutely flourished here because for some reason the terrain was very, very receptive. So she came and soon after, Paula Heimann.Then a few years later came the big wave of immigration from Vienna:Anna Freud and all the people who later became what they called Freudian.We call them Anna Freudian, because of course Mrs. Klein considered herself Freudian and thought she was more in Freud’s traditions than Anna Freud or, let’s say, ego psychologists today. They came with this big Viennese tradition, feeling that they were really Freud’s successors and arrived in England where the influence of Klein was so strong, which of course led to great turmoil. It was a fight of two women over who was the true daughter of Freud. Jacqueline Rose: I’d like to draw together two things you have said. One is your interest in left-wing politics and social concerns, the second is the fact that, in your case at least, you came to Kleinian thinking through the war context and a specific history of immigration. I am wondering if, together, they might relate to one of the things that interest me most about your work, and that is the way you take up issues of contemporary politics and culture. I am thinking of your work on nuclear rhetoric, but also discussions I have seen you participating in on television – the programme Voices which raised, among other things, the issue of child sexual abuse, and the After Dark discussion on pornography.Analysts seem to be very cautious about participating in public debate – I assume for clinical reasons – which can produce a sense that the analytic community is cut off from the world outside. Can you say something about what you see as the appropriate relationship, or limits to the relationship, between psychoanalysis and the public sphere? Hanna Segal: Certainly I think the immigration issue is very, very important – what Ricardo Steiner refers to the psychoanalytic 240

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‘diaspora’ – but there is also the question of the kind of personalities that become psychoanalysts, the traits they might have in common. A colleague of mine, Elizabeth Spillius, who is an anthropologist by training, says her off-the-cuff impression is that it is people who feel, or who are, outsiders, which would apply to this big immigration, the fact that so many analysts are immigrants. Now with me, it starts long before that because I was a displaced person before the war. I was born in Poland and was very attached to Poland. I very much resented it when my father emigrated to Geneva to become a journalist connected to the League of Nations, when I was thirteen.When I was sixteen, I went back to Poland by myself, with my parents’ agreement – it was a civilised adolescent revolt (like many sixteen year olds I preferred to live on my own) – explaining to them that it wouldn’t do for me not to have a Polish secondary school qualification in case I ever wanted to go back. I spent two years in secondary school and three years doing medicine there.And then came the enforced emigration and by then my father was in Paris. I was visiting my parents in August 1939 and got stuck there. I made every effort to go back, I mean one is very foolish at that age. I and my friends fought to get back on the last train to Warsaw to defend our country and even my parents were taken in by it. They were very worried, but they considered it natural. I don’t think a single one of my friends who got on that train survived. So I had more luck than reason. But I don’t think my interest in social matters springs from that. I think from my own analysis it springs more from my identification with the underdog. I lost a sister when I was very young who was very important to me. Or else it was just a matter of temperament. Psychoanalysis and politics is a very tricky issue. I understand the caution of my colleagues because the first psychoanalytical duty is, so far as it is possible, not to impose your own convictions, however powerful they are, on your patient. You must be aware of those convictions. In some ways I find it is almost easier to analyse people of another culture because you don’t unconsciously collude with cultural patterns which happen to be your own, so I don’t blame my colleagues for saying don’t get mixed up in it. On the other hand, I think psychoanalysis can have an enormous influence in an indirect way by throwing light on phenomena. That’s why the work of those in the Tavistock Institute of Human 241

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Relations, or Bion’s work on groups, which to me is fundamental, are all so important. Our influence has to be very indirect, but anything that draws people’s attention to phenomena or creates awareness and integrity eventually percolates. For instance, primary school education, both nursery and primary, in England after the war was probably the best in the world.Alas, alas! Those days. I am sure that a large share of that was due to the influence of Susan Isaacs on the Institute of Education, as well as to the gradual percolating of the ideas. But there are certain situations where this may lead to living in an Ivory Tower. In Argentina, the so-called more classical analysts, and that includes Kleinians, were only concerned with the consulting room whilst people were disappearing and being destroyed outside. People like Maria Langer then abandoned analysis and became very wild in their practice.Whereas psychoanalysts could take a stand.There are basic issues of human rights beyond politics when I think psychoanalysis has to take a stand. Also it is a matter of what you analyse, because I do not believe that you could analyse someone well if thousands of people are disappearing and being tortured and it doesn’t play a part in the material. It would mean there was something wrong with the analysis, because if you take up the patient’s denials of internal and external realities, they become more aware of what goes on around them Jacqueline Rose: From what you say about Maria Langer, it sounds as if there was a split in Argentina between those who held onto traditional clinical practice and those who became more political, but whose analytical practice then went ‘wild’. In his book The Repression of Psychoanalysis: Otto Fenichel and the Political Freudians,282 Russell Jacoby discusses the split between the culturalists in America with their stress on the family and politics, who discarded the classical concepts of psychoanalysis, and the classical Freudians who held on to those insights but who tended not to engage with political or cultural questions. Is this a pattern? Hanna Segal: Reich was of course central to that. It is very difficult to integrate the two without causing confusion – they are different tools. What Maria Langer, whom I knew very well, and Emilio

282 Jacoby, R. 1983.

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Rodriquez, whom I supervised as a student, were doing was ‘psychoanalysis at the service of the revolution’. I don’t think psychoanalysis can be at the service of an ideology, whether a religion or a political movement, because psychoanalysis aims at the discovery of psychic truths. On the other hand, as I say, there are issues, such as Nazism, on which it is impossible not to take a stand. As individuals, many analysts, such as Muriel Gardiner, who was an underground courier, did an enormous amount, but in those days analysts didn’t really have the conceptual weapons to make an analytical statement about what was going on.Today, our knowledge of group mechanisms gives us a conceptual weapon for saying: ‘Look, in this group phenomenon, such and such is happening, take a good look at it’. At a psychoanalytic symposium I attended in Boston, the Americans were asking why it is that patients never bring nuclear issues to the couch. I suggested that it may be because of the way you analyse, because if you just analyse at the oedipal level and don’t go into the paranoias and terrors of death, then patients are less likely to bring these political realities to analysis. One analyst at the symposium, Dr. Jacobs, also said that, in the past when a patient would start talking about political issues, he would more or less tell him that that was not what he was there for. Whereas today, if a patient says:‘I saw such and such a programme but that’s not what I am here for’, he would say:‘Why don’t you want to talk about the political programme you have seen?’ So they are moving in that direction. For me, of course, the hard decision was to go public because it exerts an undue influence on patients when they hear me outside the consulting room expressing my views. Jacqueline Rose: You mean that if you go public on a political issue it affects the patient, because they might identify with you or react against you? Hanna Segal: It is better if they react against you, than if they identify with you. Jacqueline Rose: Better psychically but not politically in this case. Hanna Segal: No, better even politically, because you can analyse the reaction and then you know that if they may come to the same point it is their own.The worst thing is if they become enthusiastic because you are. But I do want to say Moses Laufer, who by the way is a classical Freudian, and myself, as the co-founders of 243

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Psychoanalysts against Nuclear Warfare, thought that the issue was so important that a public stand had to be taken. Jacqueline Rose: You say that the analyst must not impose her or his political convictions on the patient, that in the analytic setting, the analyst must be politically neutral, so I am always very interested in those moments where that seems very difficult to sustain. In your inaugural lecture to the Freud Memorial Chair at University College, you describe a patient who equated wealth with godliness and considered poverty to be a result of fecklessness; they gradually came to recognise the unconscious greed behind these attitudes and how crippling they were. It seemed that this was getting very close to saying that a certain form of Conservatism rests on unresolved greed and persecutory anxiety. Hanna Segal: My husband was Chairman of the St John’s Wood Labour Party and he read them a paper on envy as a determinant of socialist convictions, which they didn’t like at all. It goes both ways.Whatever the political opinion of your patient, it has to be analysed. Mind you, I think I probably would not be able to analyse an out and out fascist, because I would feel unable to deal with my counter-transference.A very good friend of mine, Jean Kestenberg, a French analyst, had an ex-SS guard seek him out in consultation. He was troubled by the complications his sadism was producing in his marriage, but otherwise wasn’t at all concerned with his past, and the analyst simply didn’t take him on. He said ‘I don’t think I am the right analyst for you’. I don’t know who he sent him to, but he felt he just could not cope with that. Otherwise my sort of leftwing patients are as much under scrutiny as my right-wing people. My own left-wing tendency came under a lot of scrutiny in my own analysis. Jacqueline Rose: In your article on nuclear rhetoric, and in other discussions, you refer to Bion’s article on groups, and draw on his distinction between the ‘work group’ oriented towards reality and its transformation, and the ‘basic assumption group’, which carries and expresses psychotic anxiety. Groups, you suggest, are crazy or not according to which of these predominate. The distinction seems to be less stable, however, in so far as the objective of the work group is, for example, to ‘combat the forces of nature’.This precise endeavour, in a passage you cite, is what Freud suggests has led to mankind’s capacity to completely annihilate one another. 244

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I find that article by you immensely stimulating and quite frightening in a way because it almost seems to be saying – drawing on Bion, but perhaps pushing him further – that there is something in the nature of group formation that engenders psychosis. As you point out, there are not thirty-five million mad Americans, but thirty-five million Americans for whom being a born-again Christian is a way in which they can be mad. Hanna Segal: The group both engenders psychosis but it also helps to deal with psychosis, because group formation is also based on love, on giving up one’s own selfishness and developing concern for the group.We start as a group, first as a baby on the breast.The baby overcomes its ruthlessness with the breast, the whole family follows and then its concerns get wider. So there is something very positive in group organisation which protects us from night fears and from fears and hatreds combined.And which slowly sort of socialises us, or socialises our psychosis, which is the dangerous part – the part Bion wrote about. In certain situations, it’s a matter of the tail wagging the dog. For example, so long as a country is under territorial dispute, it’s a good thing to have an army because you have to be safe. I have discussed a lot with Air Commodore Mackie how important the feeling of security is socially. It’s OK so long as the army is the arm of the whole social organism. Of course, people who join the army must be paranoid and combative in essence – it’s a way of keeping them in place and of organising the security of the whole group. But it very easily gets out of hand because the group increases psychosis as well as controlling it.We know what happens when the army or church take over government. People who know more about it are people who actually work with groups. Jacqueline Rose: Could you say something on the child sexual abuse debate that has followed Masson’s book,283 on the question of whether these are real events or fantasy, and how psychoanalysis today deals with the reality (or not) of childhood seduction. Hanna Segal: Freud never said that no child was ever abused. He said that not every neurotic has been abused and that sexual abuse is not the cause of neurosis as he once thought.What Masson says about

283 Masson, J. 1984.

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Freud’s distortions are not true – Freud is much more convincing when he says that it cost him a lot to abandon his cherished theory. Having said that, there is a lot more child abuse than we used to think and it is very important. It takes a whole range of forms – violent, violent and sexual, and subtle-psychological. So it absolutely is there and one must not deny it, but must watch out for it in the patient’s material. But of all the many patients I have had, incontestable sexual child abuse had happened in only two female cases and in one more patient, a mental, eroticised child abuse by the mother had taken place to a degree that could be called child abuse. So it is not quite as widespread as one might think. Now, how to deal with it? Certainly not always by shifting children away from parents, certainly not by carrying out anal tests on all the children to check if they have an anal reflex. Also, there is a problem with the emphasis of some of today’s psychotherapists on saying to the child: ‘It is not your fault, don’t blame yourself ’, because they leave no place for unconscious guilt. You have to analyse unconscious guilt, whether the child is really ‘innocent’ or, as in some cases,‘guilty’. A typical situation is when the mother is pregnant and the father or stepfather and the other child get together, both like deprived, angry children (only an infantile adult abuses a child). Either way, of course, the responsibility always lies with the parent, since it is the child’s nature to be seductive. But, in relation to the child’s inner world, it is no good telling the child he is not guilty when he feels guilty, since it is only after you have analysed that guilt that the patient comes to the conclusion: ‘But of course I was, or am, a child. I trusted them to deal with that’. Still, child analysis is not the only way. One has to deal with the parents, sometimes one has to separate the child, in other cases it is better to give support to the parents. But one should never take the line:‘You’re not at fault, don’t blame yourself ’.What you could say is: ‘You feel very guilty because you maybe thought it was your fault’.That puts it into a different perspective. Jacqueline Rose: Can one say that a child might unconsciously desire something but it doesn’t mean the child wanted it? Is that a fair distinction? Hanna Segal: Yes, I think one can make that distinction.After all, the curse of the schizophrenic is that their wishes come true. Their 246

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omnipotence triumphs. And, of course, the terrible thing for the child if they have got unconscious fantasies which the parent acts out, is that then, they cannot distinguish between fantasy and reality and that goes for violent abuse too. Every normal child at times projects onto the parents that they are violent monsters, but then the parent behaves differently and gradually you distinguish your fantasy from the reality. Now when the parent acts out your worst, or best, fantasies, it is the worst thing that can happen, not just because of the suffering but because it obliterates the very distinction on which our sanity depends.The existence of the bomb does the same thing in the social sphere. As Glover284 puts it, our worst phantasies can come true and obliterate the achievement of having worked out what’s a nightmare and what’s reality. Jacqueline Rose: Since this is a new journal for women, can you say something about what Melanie Klein had to say about the psychosexual development of little girls? Do you think Kleinian thinking has a contribution to make to feminism, and what do you think of the interest shown by feminism in psychoanalysis and its attempt to use psychoanalysis to try and produce some kind of change in political consciousness? Hanna Segal: Well, I will deal with that very briefly because my feelings about feminism are very ambivalent to say the least. It depends on what you call feminism.There was a lot of controversy, and there still is, about female sexuality. People who emphasise how macho Freud was, which is true, both as a patriarch and in his phallocentrism, forget two things. One is that he was the first to treat women and their sexuality seriously.The second is that from the beginning in the analytic community, as soon as they appeared, women were allowed to play as important a role as the men. Even though Freud’s first five followers were men, Lou Andreas-Salomé had an enormous influence on Freud. Also, other people, like Ernest Jones, disagreed with Freud about female sexuality. From the analysis of small children, I don’t think there is any clinical evidence for Freud’s idea that the little girl doesn’t discover her vagina until puberty and thinks she’s got a penis.When I give my lectures on female sexuality, I always bring

284 Glover, E. 1947.

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in the case of a little girl in which it is absolutely transparent that she is aware of her vagina, she is even aware of her potential for babies, she masturbates vaginally, not clitorally, pushing her finger in whenever she experiences anxiety. So, from her observation of children, Klein simply started by saying that little girls, like little boys, know their sex. She treats the girl’s phallic phase as a defensive construction. For Klein, both little boys and little girls are aware from very early on of the mother’s body, of the wish to explore it, of the wish to be inside it and both have the competitive desire to be like the mother. She called this the boy’s feminine phase which exists alongside the penetrating, possessive desire to possess the mother, with the conflict taking place between the two. Now, why is it that for the little boy, in normal development, the masculine predominates and the feminine is sublimated and the reverse takes place in women? This is more a point that I make as a development of Klein that it has to do with the reality sense. Healthy development means you recognise your internal reality and its interplay with external reality and one of the internal realities is the reality of your sex, of your actual physical sex. PostKleinians (although it is implicit in Klein’s description of the depressive position) stress the importance of the parental couple and the couple as a creative relationship – they have produced a baby. The true Oedipus complex involves recognising that and recognising the hate, jealousy and envy it provokes.The fantasies of going off with daddy or going off with mummy are really defensive structures against those feelings – an oedipal myth as distinct from the oedipal reality underneath.Any deviation from sexuality of that kind is an internal attack on the parents as a couple and in that sense is not really a completely healthy development. Jacqueline Rose: I would like to come back to that question of deviation later. Staying with this issue of the girl’s development, can you say a little more about whether in this account the girl has an easier or a harder time than the boy, if there are any differences you would make about this? Hanna Segal: I have quite definite views on this.All my male patients think if only they were little girls how easy life would be and all my female patients think if only they were little boys how easy life would be. I don’t think it makes a pennyworth of difference. It is like asking whether it is worse to be the older child, or the younger 248

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child or the one in the middle. Now, in our culture there is an advantage in being a boy, there is no doubt about it, but unconsciously I think that for both sexes the first idealised object is the mother. Jacqueline Rose: Does it then make a difference for the girl in so far as the boy ends up, as Freud would say, with an object of the same sex, whereas the girl has to, not only renounce, but also identify with somebody who was her first love object? Does that make it more difficult? Hanna Segal: But the boy has to renounce his first object as well. Because he has to relinquish a desire for the breast. I think it has to do with overcoming narcissism. Both have to overcome the position that they own the breast or are the breast. Jacqueline Rose: Your point about the child having to overcome narcissism and accept sexual difference sounds to me not unlike Jacques Lacan’s account of the passage from the imaginary relation with the mother to the symbolic order of social law.Also when you describe how the girl must relinquish her desire to satisfy the mother heterosexually (in your first book on Klein you talk of her homosexual desire for it), it seems to come close to his account of castration – that the little girl cannot be the ‘phallus’ for the mother. In your essay ‘A psychoanalytic approach to aesthetics’285 you also talk of the relation between language and loss of the object and mourning for sexual impotence. Is there any possible point of dialogue here between Lacan and Klein? I was interested to discover from Phyllis Grosskurth’s biography of Klein that Lacan offered, and then failed, to translate Klein’s The Psycho-Analysis of Children. It seems to me that he was more dependent on her ideas than some of us realised before. Hanna Segal: Yes. A number of young French Lacanians told me at one time that I was the only analyst that Lacan thought well of, but that may have been before I became very explicit that I didn’t think the same of him.There are similarities and differences. I think that the similarity is the overcoming of what I call concrete symbolism and the passage to real symbolism which is related to loss, but also to the recognition of aggression and guilt, which Lacan leaves out

285 Segal, H. 1952.

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a bit. He also reduces it often to the loss of the phallus. He also doesn’t acknowledge enough that this kind of work went on before him. And he made everything much more abstract, which I don’t like in his style. He also contradicts himself a lot. For example, at a conference one morning I heard a paper which said ‘L’enfant ne connâit le père que par le discours de la mère’ (‘The child only knows the father through the discourse of the mother’).Then in the afternoon a paper was titled ‘Le discours est toujours le discours du père (‘Discourse is always the discourse of the father’). It becomes like the Bible – all sayings and aphorisms.There is also a deification of language.When Lacan says that the unconscious is structured like a language, I think it is the other way around, that language reflects the structure of unconscious relationships, because like all symbolism it is based on those relationships. I think that the role of the father in development, not only of language but of symbolisation, is to intervene into the state of projective identification where there is no third object and the child is in possession of the mother.The structural role of the penis in fantasy is to stop a stream of mutual projective identification between mother and child. In reality, that is the role a good father plays by stepping in as the third object. I also think that Lacan is phallus-obsessed and doesn’t differentiate enough between the phallus – which is the urinary, exhibitionist, narcissistic object – and the genital penis. The penis that serves its role in my scheme of things is the genital penis (the father in intercourse with the mother and in a relationship with her).The law is not so much the law of the father as a certain law of depressive versus schizophrenic relationships.We also differ on narcissism, because for us narcissism is always based on object relationships and is related to projective identification and envy, whereas I think that Lacan holds with primary narcissism as a state from which we have to emerge.The main differences between Klein and Lacan are of course technical. Seeing patients for five minutes, coming into a waiting room full of people and deciding ‘Today I see you’ then charging the earth for it – that is not the way we practise psychoanalysis. Jacqueline Rose: One of the things that sometimes concerns people about Klein, in comparison with Freud, is that she seems to stress much less than he did the price you pay for normality, so I am very interested in the fact that one of the first books you read by Freud 250

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was Civilisation and its Discontents. Freud seems to present failing as part of the human condition and not as personal failure, whereas Klein seems to have a much clearer sense of what constitutes normal and pathological development. Hanna Segal: I have never thought of it from that angle but I think that the price of normality is overcoming omnipotence and it is a heavy price to pay.When Freud talks of reality sense, he is referring more to external reality. This emphasis has been taken up by American analysts which I don’t like because it often leads to becoming conformist and adjusting as best as you can. I think that reality sense means being in a state of mind where you know yourself and don’t project, so you can assess reality and know what can be achieved and what can’t. For instance it means giving up idealisation, but it doesn’t mean giving up idealism, only being realistic about what can be achieved, which is a very heavy price to pay. To know how far you are from what you would wish to be, whether individually or socially. Jacqueline Rose: But you don’t have an idea of civilisation as oppressive in itself, or of the law of heterosexuality as an oppressive social law because it obliges you to give up a more complex, polymorphous sexuality? Hanna Segal: No. I do think that society is extremely oppressive in that our society is dominated by envy and greed which can be maintained by tyrannical regimes. But that giving up polymorphous sexuality is a heavy price to pay, I don’t really think so at all. Partly because the rewards are so much greater and partly because the perversion in fact exacts a very much higher price. Jacqueline Rose: This should be the point where I ask you about perversion, but we have left behind the question I asked you earlier about feminism – its use in psychoanalysis and if you think Kleinianism has a contribution to make to feminist thought. Hanna Segal: I do think Kleinianism has a big contribution to make to feminism because it states from the beginning the woman is a valued – some people complain, more valued – than the man.They are equal and different, but unlike perhaps some other feminists Klein also emphasises the differences, that part of normality or of the recognition of reality which is the difference of generations, and genders.Those who want unlimited sexual freedoms want not only to obliterate the difference of genders but also of generations. 251

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I have seen it with some adolescents – all they want is to be loved forever and to have the parents carry the consequences.That is a caricature of course, but it is interesting that psychoanalyticallyminded feminists are hung-up on Lacan who, of all the Freudians, is the most phallic oriented. The feminist movement is a very broad thing. I am very much in favour of a tough fight for equal pay, equal conditions, equal but different in say the provisions for nursery care, etc. I am very much in favour of internal alterations to the family structure, because I think that not only the woman but also the man is deprived. He is deprived of his right to the children, to his feminine part. How many women’s potential for creativity has been quashed by the family structure? How many men with the potential to be a good father or husband are pushed by a culture to be out of the home from 6 in the morning until 8 at night in order to earn a living or make a mark? I am very much in favour of changes to that picture. What I am against is man-hating. After all, racism is bad enough, but man-hating affects fifty per cent of the population. I rather happen to like men, but even if I didn’t, you can’t be anti fifty per cent of the population! Jacqueline Rose: I agree with you, but I think that the image of feminists as man-hating is a caricature of feminism. Hanna Segal: Two lesbians adopting a baby. I read a paper by a lesbian, who said she couldn’t go near a man out of physical horror, and that she and her girlfriend adopted a baby, a beautiful little boy. What the hell is going to happen to this boy when he reaches adolescence? But without going to extremes, in much of the feminist literature, there is a kind of undercurrent: men are aggressive, uncommunicative, out of touch with feelings, etc. Oh! If only you were more like women, how lovely it would be! Jacqueline Rose: Doesn’t Freud say that a married woman, for all her apparent heterosexuality, can be unconsciously carrying over her relationship with her mother on to her relationship with her husband? And of course marriages break up and they can do so because of the unconscious weight of a whole range of positions. What I am trying to get at is that the actual social arrangements of mothering don’t automatically reflect unconscious fantasies. Hanna Segal: That’s right. But it is also like the question of child abuse. A mother can be too attached to her mother and have 252

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homosexual impulses but that is not the same as actually living as a lesbian with another woman. Once you come to that things are different. Jacqueline Rose: You have said that you think that homosexuality is an attack on the parental couple, a repudiation of reality and is almost invariably accompanied by a perverse personality structure. I wonder if you could say a little bit more about homosexuality and perversion. I am thinking, for example, of Joyce McDougall’s286 concept of neo-sexualities which does not seem to classify sexuality as perverse according to object choice. One of the reasons why I am asking this is because there is a worry that Kleinianism is moralistic and homophobic. Hanna Segal: I don’t know. I was part of the working party from the Psycho-Analytical Society that gave evidence to the Wolfenden Commission287 and I think we had quite an influence on liberalising the laws. I am against any oppressive laws against individual freedom except when it comes to child abuse. Homosexual child abuse may be even worse than heterosexual, but I am not sure.And of course there is also an enormous range of homosexualities. Freud didn’t call homosexuality a perversion because there are much more perverse perversions than homosexuality. And who is symptom free? I would not call it normality because it is a developmental arrest. But I would not legislate against it. For example, I would not legislate against obsessions unless their obsessionality damaged other people – but that doesn’t mean that I consider it constructive. Jacqueline Rose: In your paper on aesthetics,288 you talk about creating a work of art as a ‘genital bisexual activity . . . a psychical equivalent of procreation’ and you distinguish good and bad art according to the artist’s negotiation of the depressive position. It seems therefore as if the artist is in some sense exempted form the link elsewhere in your work between working through the depressive position and relinquishing bisexuality. Is there a place in your thinking for a creative homosexuality? 286 McDougall, J. 1986. 287 The Wolfenden Report was a 1957 government study which recommended homosexual behaviour between consenting adults no longer be criminalised. 288 Segal, H. 1952.

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Hanna Segal: No, I think that creativity is achieved by overcoming those things, as with depression. Probably artists have more of it, but the art consists of reaching something more integrated. Jacqueline Rose: Where does that leave Shakespeare’s sonnets? Hanna Segal: Many artists are very, or clinically, depressed – think of Van Gogh, think of Conrad – but that doesn’t mean that depression in itself is a non-neurotic condition. My favourite writer is Proust and his is a book about homosexuality. On the other hand there are a lot of myths that homosexuals are more artistic and creative. You speak of the price of civilisation – the price of civilisation could be losing too much of the unconscious. I think artists generally have more acute problems than other people.You could say there is an affinity between artistic creativity and homosexuality. There is certainly an affinity with voyeurism and there is an affinity with repression.What matters is how much of this you can cope with and eventually integrate. Jacqueline Rose: Isn’t there a danger (and do you think that psychoanalysis should take account of this) of a complicity between the idea of a perverse personality structure and very widespread and quite dangerous attitudes against homosexuals as ‘perverts’? Hanna Segal: Most analysts today ask:‘What do you mean by perversion?’ And yes, we do have to be careful, but we can’t follow fashions either way. I have had homosexual patients who came to be cured for all sorts of other things but who wanted to preserve their lifestyle. It just doesn’t work, as everything has to be analysed. To come back to your saying that analysts, and Kleinians in particular, are homophobic, I think there is a confusion here between clinical judgement and an attitude of moral superiority.An analyst, worth his salt, knows about illness from the inside. He doesn’t feel, ‘You are a pervert unlike me’. He feels,‘I know a bit how you came to that point, I’ve been there, am partly there still’. If he believes in God, he would say:‘There but for the grace of God go I’. But my clinical judgement is that homosexuality is of necessity a narcissistic condition, as the name itself betrays. Loving homo – the same as me not hetero – the other, different. Heterosexuality can be more or less narcissistic. In homosexuality it’s inbuilt. Jacqueline Rose: And yet Freud talked of a bisexual dispositions in all of us. 254

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Hanna Segal: That was our trouble with the Wolfenden Report – how to convey both that a homosexual part of the self is normal – we identify with both parents – and yet we consider the adult homosexual structure to be pathological. But that is true of all infantile traits.We must be aware of them as part of us and yet other more mature choices have to be made. Jacqueline Rose: But doesn’t that link between homosexuality;‘immaturity’ and ‘choice’, reinforce prejudice against homosexuals, especially in the current climate of the backlash against homosexuals? I am thinking of the AIDS scare and Section 28.289 Hanna Segal: The backlash against homosexuality mobilised by AIDS is horrible. But not surprising – we always look for pariahs: Jews, blacks, homosexuals and the diseased – the lepers. I do not think analysts ever contribute to that. But we do sometimes have trouble with the reverse: the idealisation of the condition. Not only is homosexuality idealised by many as somehow superior, but the fact of AIDS being an illness is often denied and, in some support groups and with some counsellors, who are often homosexual, there is a strong denial of AIDS as an illness and a feeling of being part of a somewhat superior group. In a recent case I supervised, it was quite an achievement in the man’s analysis that he recognised it enough to get medical care for his condition. But of course with AIDS, behind the denials, there is such despair. Jacqueline Rose: I’d like to come back to the question of normality and development in Klein, to the issue of what, in her account, causes things to ‘go wrong’.At moments in her writing, and in your commentary, it seems to be a constitutional factor, at others it seems to be the quality of the child’s experience, at others it seems to be more a question of the parents, specifically the mother’s unconscious. Kleinians are often criticised for laying too much emphasis on the instinctual and not enough on the outside world. In your second book on Klein you yourself suggest that she stressed

289 Section 28 was an amendment by Parliament of the Local Government Act in 1988 which intended to stop local authorities promoting homosexuality (i.e. council funding of books, leaflets, films or any other material showing gay relationships as normal was banned).

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the constitutional factor more as she got older, almost in despair at the limits of therapy. I wonder if you could say something about this tension between inner and outer worlds. Hanna Segal: I think anybody believing that everything is innate would be a bit crazy. It is a position attributed to Klein despite all she said about the presence and love of the mother in the resolution of the depressive position. But anybody who thinks that everything is environment, that we are born ‘tabula rasa’ is just as cuckoo.You have only got to see a day-old baby, or the infinite variety of human temperament, to know that.There is a constant interplay between the inner and outer. On the inner side, there can be a number of factors. It could be ego strength, it could be an ability to bear frustration, it could be the preponderance of the death instinct and envy. In the end they all come to the same thing in a way, and that is the constant, omnipotent attack on reality because the ego is too weak, or the envy is too strong, or whatever factor is predominating on the inside. From the outside, every good experience contributes to strengthening the positive fantasies and the belief in them and every bad experience does the reverse.And that is that. Now, when I look at my patients, you can always see the pathology of the mother in the bad circumstances reflected in the child. But it is not a one-to-one relation at all. I always quote two cases that I know well, though I didn’t analyse them. An autistic child with absolutely devoted parents, whose mother had a mild depression after birth and whose parents were a bit too involved with one another, very, very much in love throughout their life. That child is autistic. And in his analytic material you can see the mother’s depression, or the parent’s over-involvement. Now I know another child whose mother was hospitalised for a severe depression, one of whose features was a desire to murder him, and whose father was pretty well absent and a bit psychopathic. Worse, very much worse. In that child you could see the parental pathology reflected in him absolutely, but he was a neurotic.You don’t get a one-to-one correlation, there is also something like resilience, and what comes from inside. It could be that there are such circumstances in which no child could come out unscathed.There are also such children that would need almost perfect parents to deal with some inner defect. 256

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It is usually put moralistically that Klein ‘blames’ the child. It is not a question of blame. If the child was born premature, if the child was born with a certain constitution, is he any more to blame? My adolescent son used to tease me:‘Mum, it’s always your fault. If it’s environment, it’s you.’ If it’s genes, it’s you. So what’s the problem? It is not a matter of blame.Also, for me, if it is the mother, it does not mean that she is wicked.You would probably need to look at her parents, her personality, but you must look at the interaction between the mother and child. In analysis it is important not to side with the child: ‘Poor little thing, what did mother do to you?’The child himself or patient must come in the end to accept the reality. Sometimes children idealise the parents and it takes a very long time to them to admit – no, it wasn’t them but was really something in the parent. Sometimes it is harder than the other way around. Jacqueline Rose: That is a very important point, because one assumes it is easier for the child to blame the parents or the outside world, but it can be the opposite. Hanna Segal: Yes, it can be the opposite.

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28 Hanna Segal inter viewed by Dor r it Harazim

This interview was published in Veja, a weekly Brazilian magazine with a wide circulation.290

During one of her rare visits to Brazil, Melanie Klein’s favourite pupil talks about the extraordinary adventure that is the human mind. Acclaimed as one of the greatest pioneers of psychoanalytic thinking, Hanna Segal, at the age of 80, continues to work from her London consulting room, publishing books (Psychoanalysis, Literature and War has just been released in Brazil by Imago Editora) and living on the borders of politically correct conventions.As often as she can, she smokes cigarillos (‘the Brazilian ones are some of the best in the world’) or a cigar (‘it’s a Havana or nothing’), punctuating every reflection with a puff.‘Unfortunately I had to abandon the pipe,’ she laments. She admits that, despite her Jewish origin, there are irreconcilable differences between her values and the predominant culture in Israel, and she has also little sympathy for the feminist movement. A former Freud Memorial Visiting Professor at University College London, Hanna Segal met with Veja, wearing Birkenstock sandals, shorts, and with a desire to finish the interview as soon as possible, so she could go for a swim.

290 ‘Hanna Segal interviewed by Dorrit Harazim’, Veja, Vol. 31, no. 16, 22 April 1998.

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Veja: How is psychoanalysis surviving the Prozac era, with pharmacies full of cheaper drugs that work faster and are more seductive than traditional therapies? Hanna Segal: I’m not 100% against the use of drugs in prolonged cases of psychosis.What seems dangerous is to use them when you have perfectly normal, real reasons to be depressed. Someone who has never experienced depression, but then suffers from it when a spouse dies, for example, does not need to be chemically ‘lifted’ by Prozac. On the contrary – the process of depression should be digested and allowed to take its course naturally. I’m also against the use of drugs to treat neurotic disorders – drugs can temporarily suppress the symptoms, but they perpetuate the process at the source of the disorder. The Prozac culture offers no room for reflection. It’s like using a hammer to kill a fly – a bit like lobotomies.The damage that this can have on a person’s mental state is incalculable. Veja: And in relation to children? Hanna Segal: It is even more worrying, because it can prevent the normal development of a child. Veja: Not having an understanding of psychoanalysis, a century after Sigmund Freud made his discoveries – is it a form of illiteracy? Hanna Segal: There’s a crucial difference between the two ideas. While the illiterate is too ashamed to admit his condition, when it comes to the field of psychoanalytic ideas, people continue to be proud of having no knowledge of psychoanalysis.As one refuses to acknowledge fundamental psychoanalytic ideas, what ends up being implicitly believed is that psychoanalysis is wrong.As a result, ignorance destroys knowledge.The greatest desire of the illiterate person is to learn how to read and write.The pride of the person with an aversion to psychoanalysis lies exactly in their choice to renounce it. Veja: Do women seek self-knowledge more than men? Hanna Segal: I don’t think so. There are people of both sexes who cannot deal with profound emotions, period.The fact that women talk more means nothing – it can even be a defence-mechanism. It’s possible to speak too much and yet say nothing, to reside in a superficial bubble. Veja: In fifty years of clinical work, have you ever encountered a patient who didn’t need psychoanalysis? 259

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Hanna Segal: My guiding principle is that if someone wants to see me, it’s because they need some sort of help. However, depending on the individual case, I have on occasion suggested that a patient should take time to consider and perhaps come back at a later stage. Veja: What do you think of the increased popularity of self-help manuals? Hanna Segal: I don’t think it causes damage – however, it does encourage a form of omnipotence, in the sense that it suggests ‘I can solve everything by myself ’. Veja: And what about those television talk shows, in which participants attack one another, and expose their crudest perversions in front of the cameras? Are they not, in a sense, a by-product of psychoanalysis? Hanna Segal: Yes and no. I’m 80 years old, and elderly people are generally prejudiced about new things.Taking that into consideration, I do think that these shows are directed towards sensationalism, momentary excitement and trivialisation. We are subjected to so much violence, so many sexual perversions, so many kinds of abuse, that these things inevitably become trivialised. I know, through my experience with patients, that this type of television programme provokes a kind of instant orgasm, a quick sexual excitement. Veja: Isn’t the actual concept of perversion rather dangerously amplified? In the USA, hugging a child can sometimes be misconstrued as a form of sexual abuse. Hanna Segal: Yes, I believe that this is precisely due to with the exploitation of sexuality. As soon as these people become censors, they can legitimately enter into the forbidden universe of violence. It’s obvious that sexual abuse should be investigated with the utmost rigor, because it has been proven that its practice is more disseminated than previously suspected.The danger is that it can be turned into witch-hunt, when teachers can no longer physically show affection for their pupils, and parents begin to think twice about embracing their children. Veja: An industry has been created out of this, don’t you think? Hanna Segal: Personally, I am very suspicious of psychoanalysts and psychotherapists who ‘specialise in child sexual abuse’. A psychoanalyst does not specialise in anything but the study of the human 260

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mind. They should not concentrate on or stimulate a particular aspect of a patient’s pathology. Veja: Some perversions go in and out of fashion according to the era. At the turn of the century, sleepwalking was at a record high. More recently, we’ve had anorexia nervosa and the multiple-personality epidemic.What are the mental disorders at the end of this century? Hanna Segal: It’s not the mental disorders that change, but the diagnoses. Hysteria, for example, is still as widespread today as it was in Freud’s time. Veja: In popular culture, hysteria was always considered to be a female disorder, especially at the turn of the century, at the time when the feminist movement was taking shape. The word ‘hysteria’ itself comes from the Greek for ‘uterus’. Is there any fundamental truth in this association? Hanna Segal: None. Presumably, when doctors detected the symptoms in men, they treated it as a physical problem.With a woman, it could only be hysteria. Veja: In the USA there is a Society against Psychoanalytic Fraud, founded by a patient whose life was destroyed by 12 years of inappropriate therapy, who ended up winning $2.7 million in damages. In your opinion, should patients be protected against errors of diagnosis and treatment? Hanna Segal: Yes, even though this is a very difficult issue. So many absurd things go about under the name of psychotherapy and psychoanalysis! It reminds me of an advert I came across in the British magazine The New Statesman, offering,‘massage, colonic irrigation and psychoanalysis’. I believe that psychoanalytic societies in each country – who are responsible for training psychoanalysts – should be more severe in their ethical evaluations.The hardest thing is to achieve some sort of consensus in the International Psychoanalytical Association – because something that is considered as abusive by the psychoanalytic community of one country is not necessarily seen in the same way in another. Veja: You have already been the president of the British Psychoanalytical Society and you were also at some point the vice president of the International Psychoanalytical Association. You may remember the case brought forward by Dr. Helena Besserman Vianna, a leading Brazilian psychoanalyst from Rio, who denounced a medical doctor,Amilcar Lobo, who was a trainee 261

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psychoanalyst, for taking part in the torture of political prisoners during the military dictatorship in Brazil, and the fact that the IPA did not accept her accusations.What are your views in this respect? Hanna Segal: I know the case well. In my view, any person involved with torture or any other form of destructive activities should immediately be expelled from the psychoanalytic society. This is not a moral position, but an ethical one. Essentially, our profession works towards helping people to not destroy themselves. Veja: Isn’t the corporate nature of the profession very strong? Hanna Segal: It had been worse in the past. In cases like that of Amilcar Lobo, one could have felt compassion for him if he had been threatened with death and torture. This wasn’t the case, I know. But even if it had been, I believe that he would have been too damaged by the experience to be able to practise psychoanalysis. When you are faced with fear of death or the threat of torture, you become capable of acting in a way that you know to be, essentially, terrible. Under these circumstances, I don’t think one’s personality could recover sufficiently in order to be able to practise psychoanalysis. Veja: What was Amilcar Lobo’s training supervisor’s responsibility at the time? Hanna Segal: A supervisor is not responsible for the pathology of his supervisee, but he should not, in any circumstances, condone or cover up criminal activities. Veja: All the great names in psychoanalysis were Jews. Why is psychoanalysis not consequently more developed and discussed in Israel? So many holocaust survivors have rejected the idea of going into analysis. Hanna Segal: The great names in psychoanalysis were not Israelis, but they were Jews – associated to the Yiddish culture (Ashkenazim Jews), and in many cases strongly assimilated, like Freud.The Israelis tended to despise this type of intellectual culture; they tried to cut all ties with the Yiddish culture. In the case of holocaust victims, it has been statistically proven that the children and grandchildren of survivors who have been able to talk about their experiences develop better than the descendants who are reluctant to speak openly about it. Veja: The American historian Hannah Arendt suggested that by making the extermination of Jews in concentration camps 262

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anonymous, the Nazis were able to take away the most profound significance of death – the end of an individual’s life. They dehumanised death.What could be the consequences of this fact? Hanna Segal: One of the consequences of dehumanising death is the absence of the symbolic survival. In normal circumstances, we face death knowing that our children, our work, our world, nature will survive. Even the Jews in concentration camps maintained a notion of symbolic survival – they never thought that the world would end, or that the Jewish race would be finished. For that reason, they could give up their lives so that one person or another would be able to escape, so that photographs of concentration camps could be smuggled out. Moreover, in the post-war nuclear arms race, we were faced with the notion of total annihilation, without any space left for symbolic survival. Veja: Despite the implosion of the Soviet Union, you continue campaigning for the nuclear disarmament of the world.What danger does this pose to the world today? Hanna Segal: After the dismantling of the old Soviet Union, the world became like a patient who has just emerged from a paranoidschizophrenic state, who still has to face plenty of problems, yet faces them with a sense of triumph. Veja: You seem to hold the belief that groups are more dangerous than individuals.Why is that? Hanna Segal: It’s difficult to find anyone who claims, with little ceremony, ‘I am the greatest person in the world’ – even when they think they are. Nations, however, can express this kind of grandiosity with absolute naturalness – and they do it. Alone, an individual is not allowed to go out shooting hundreds of people. But if you give him a military uniform and tell him that he is defending his country, he will go and do it. In groups we accept, with relief, the fact that someone (the government, the army, the nation) is assuming responsibility for our actions.We can kill and still be heroes. We invest into groups a pathology that we can’t tolerate in ourselves. Veja: Is it possible to overcome fear? Hanna Segal: It’s not a good idea to get rid of fear. It’s better to learn how to deal with it, in the same way that we need to learn how to cope with depression. Veja: Is it possible to conclude that psychoanalytic theory is sound? 263

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Hanna Segal: No scientific theory is absolutely correct and unchangeable over time. There are always new theories, and new understandings. But there are irreversible discoveries. Modern astronomy, for example, is very different to Copernicus’s theories, but nobody today would believe that the earth is flat and that the sun goes round it. The same applies to psychoanalytic theory. Since the discovery of infant sexuality, of aggression and of the existence of vital unconscious processes underlying our conscious lives, nobody can claim that the first few years of life and infancy are not important in forming a personality. I’ll repeat something I wrote with W. R. Bion and H. Rosenfeld for Melanie Klein’s obituary: ‘All sciences search for the truth. Psychoanalysis is unique because it believes that the search for truth lies in the therapeutic process.’ Veja: Do normal people exist? Hanna Segal: We should try not to categorise normality. I’ll keep to Freud’s definition, that if you are capable of loving and working, of relating to other people, then you have the basis for humanity. Veja: At the age of 80, do you know yourself well? Hanna Segal: That’s the hardest question to answer. I would like to believe so, but at the same time I know that I don’t know myself all that well. My desire is to know myself well enough so that I can face death with maturity. I don’t know if I would be able to.

Postscript 2005 This 1998 interview had an immediate impact in Brazil on doctors, patients and distressed families of patients who had no idea of the possible counter-indications to Prozac. I am only surprised that I did not mention something I knew at the time – that a specific side-effect of Prozac is to precipitate psychosis, sometimes leading to murder or suicide in patients with no psychiatric history. Today this is widely known as well as the fraudulent role of pharmaceutical companies who apparently had the evidence and did not disclose it.

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Bibliog raphy

Abraham, K. (1911) Notes on the psycho-analytical anvestigation and treatment of manic-depressive insanity and allied conditions, published in Selected Papers, edited by Ernest Jones. London: Hogarth Press,1978: 137–56. —— (1927) A short study of the development of the libido, viewed in the light of mental disorders (1924), in Selected Papers of Karl Abraham. London: Hogarth Press. Alexander, F. (1957) Psychoanalysis and Psychotherapy. Edinburgh: Bishop & Sons. Alexander, F. and French, T.M. (1946) Psychoanalytic Therapy. New York: Ronald Press. Bion, W.R. (1956) Development of schizophrenic thought, International Journal of Psycho-Analysis, 37: 344–6. —— (1957) Differentiation of the psychotic from the non-psychotic personalities, International Journal of Psycho-Analysis, 38: 266–75. —— (1958) On arrogance, International Journal of Psycho-Analysis, 39: 144–6. —— (1959) Attacks on linking, International Journal of Psycho-Analysis, 40: 308–15. —— (1961) Experiences in Groups. London:Tavistock. —— (1962a) The psycho-analytic study of thinking (a theory of thinking), International Journal of Psycho-Analysis, 43: 306–10. —— (1962b) Learning from Experience. London: Heinemann —— (1963) Elements of Psycho-Analysis. London: Heinemann. —— (1965) Transformations. London: Heinemann. —— (1967a) Second Thoughts. New York: Jason Aronson. —— (1967b) Notes on memory and desire, The Psychoanalytic Forum, 2(3): 271–80.

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Bibliography —— (1970) Attention and interpretation, in Seven Servants: Four Works (1977). New York: Jason Aronson. —— (1997) Taming Wild Thoughts, edited by Francesca Bion. London: Karnac. Birksted-Breen, D. (1996) Phallus, penis and mental space, International Journal of Psycho-Analysis, 61: 39–52. Brenner, C. (1994) The mind as conflict and compromise formation plus discussions of same, Journal of Clinical Psychoanalysis, 3: 469–563. Britton, R. (1989) The missing link: parental sexuality in the Oedipus complex, in The Oedipus Complex Today edited by R.S. Britton, M. Feldman and E. O’Shaughnessy. London: Karnac. —— (1998) Belief and Imagination. London: Routledge. —— (2003) Sex, Death, and the Superego. London: Karnac. Chomsky, N. (1957) Syntactic Structures.The Hague: Mouton & Co.. Dante, A. (1314) The Divine Comedy. Oxford: Oxford University Press, translated by Charles Sisson, 1980. De Mijolla, A. (ed.) (2005) Dictionnaire International de la Psychanalyse. Paris: Hachette. Fink, B. (1997) A Clinical Introduction to Lacanian Psychoanalysis:Theory and Technique. Cambridge, MA: Harvard University Press. Fornari, F. (1975) The Psychoanalysis of War (first published in Italian in 1966). Bloomington: Indiana University Press. Freud,A.(1936) The ego and mechanisms of defence, in The Writings of Anna Freud, vol. 2. The International Psycho-Analytical Library, No. 30. London: Hogarth Press. Freud, S. Note that all references to the Standard Edition are denoted by the abbreviation SE and to the London: Hogarth Press edition. —— (1893–5) with Breuer, J. Studies on Hysteria, SE 2. —— (1900) The Interpretation of Dreams, SE 4 and SE 5. —— (1905) Three Essays on Sexuality, SE 7:135–244. —— (1909) Analysis of a phobia in a five-year old boy, SE 10: 5–149. —— (1910) Leonardo da Vinci and a memory of his childhood, SE 11: 63–137. —— (1911a) Formulations on the two principles of mental functioning, SE 12: 218–26. —— (1911b) Psycho-analytic notes on an autobiographical account of a case of paranoia (dementia paranoides) – The case of Schreber, SE 12: 3–82. —— (1912) Recommendations to physicians practising psycho-analysis, SE 12: 111–20. —— (1914) On narcissism: an introduction, SE 14: 73–102. 266

Bibliography —— (1915a) Papers on metapsychology: instincts and their vicissitudes, repression, the unconcious, SE 14: 105–209. —— (1915b) Observations on transference-love, SE 12: 159–71. —— (1916) Some character-types met within psycho-analytic Work, SE 14: 309–33. —— (1917) Mourning and Melancholia, SE 14: 237–59. —— (1918) From the history of an infantile neurosis (the ‘Wolf Man’), SE 17: 3–123. —— (1920) Beyond the Pleasure Principle, SE 18: 7–63. —— (1921) Group Psychology and the Analysis of the Ego, SE 18: 67–134. —— (1923) The Ego and the Id, SE 19: 13–48. —— (1924) The economic problem of masochism, SE 19: 159–70. —— (1925) Negation, SE, 14: 235–9. —— (1930) Civilization and its Discontents, SE 21: 64–145. —— (1940) An Outline of Psycho-Analysis, SE 23: 139–207. Garcia Marquez, G. (1983) Chronicle of a Death Foretold. London: Cox & Wyman. Glover, E. (1947) War, Sadism and Pacifism: Further Essays on Group Psychology and War. Edinburgh: Hugh Paton & Sons.. Grosskurth, P. (1986) Melanie Klein: Her World and Her Work. Toronto: McClelland & Stewart. Heimann, P. (1950) On counter-transference, International Journal of PsychoAnalysis, 31: 81–4. Heimann, P., Klein, M. and Money-Kyrle, R. (eds) (1955) New Directions in Psychoanalysis. New York: Basic Books. Isaacs, S. (1948) The nature and function of phantasy, International Journal of Psycho-Analysis, 29: 73–97. Jackson, J. (2000) Le passage du fonctionnement B au fonctionnement A chez un garçon violent, avec une introduction de Hanna Segal, Journal de la Psychanalyse de l’Enfant, 26: 105–39. Jacoby, R. (1983) The Repression of Psychoanalysis: Otto Fenichel and the Political Freudians. New York: Basic Books. Jones, E. (1916) The theory of symbolism, in Papers on Psycho-Analysis. London: Karnac. —— (1955) Sigmund Freud: Life and Work: Vol 2: Years of Maturity 1901–1919. London: Hogarth Press. —— (1955) Sigmund Freud: Life and Work: Vol 3. New York: Basic Books. Joseph, B. (1978) Different types of anxiety and their handling in the analytic situation, International Journal of Psycho-Analysis, 59: 223–7. —— (1985) Transference: the total situation, International Journal of PsychoAnalysis, 66: 447–54. 267

Bibliography Kant, I. (1783) Prolegomena to Any Future Metaphysics. Cambridge: Cambridge University Press, 2004. Keats, J. (1817) Letter to George and Thomas Keats dated Sunday 17 December, 1817. King, P. and Steiner, R. (1991) The Freud-Klein Controversies 1941–1945. London: Routledge. Klein, M. (1923) The development of a child, International Journal of PsychoAnalysis, 4: 419–74. —— (1927) Criminal tendencies in normal children, British Journal of Medical Pychology, 7. —— (1930) The importance of symbol formation in the development of the ego, International Journal of Psycho-Analysis, 11: 24–39. —— (1932) The psycho-analysis of children, in The Writings of Melanie Klein, vol. 2. London: Hogarth Press. —— (1934) A contribution to the psychogenesis of manic-depressive states, International Journal of Psycho-Analysis, 16: 145–74. —— (1940) Mourning and its relation to manic-depressive states, International Journal of Psycho-Analysis, 21: 125–53. —— (1945) The Oedipus complex in the light of early anxieties, International Journal of Psycho-Analysis, 26: 11–33. —— (1946) Notes on some schizoid mechanisms, International Journal of Psycho-Analysis, 27: 99–110. —— (1952a) The origins of transference, International Journal of PsychoAnalysis, 33: 433–8. —— (1952b) Developments in Psychoanalysis, edited by J. Riviere. London: Hogarth Press. Includes four key papers: Some theoretical conclusions regarding the emotional life of the infant (Chapter 6); On observing the behaviour of young infants (Chapter 7); On the theory of anxiety and guilt (Chapter 8); and Notes on some schizoid mechanisms (Chapter 9). —— (1957) Envy and Gratitude. London:Tavistock. —— (1958) On the development of mental functioning, International Journal of Psycho-Analysis, 39: 84–90. —— (1961) Narrative of a Child Analysis. New York: Free Press. Kohut, H. (1984) How Does Psychoanalysis Cure? Chicago: University of Chicago Press. Kristeva, J. (2000) Le Génie Féminin: la vie, la folie, les mots.Vol 2, Melanie Klein. Paris: Fayard. Kuhn,T.S. (1962) The Structure of Scientific Revolutions. Chicago: University of Chicago Press. Lacan, J. See entry for Fink, B. for Lacan’s writings translated into English. 268

Bibliography Masson, J. (1984) The Assault on Truth: Freud’s Suppression of the Seduction Theory. New York: Farrar, Straus & Giroux. McDougall, J. (1986) Identifications, neoneeds and neosexualities, International Journal of Psycho-Analysis, 67:19–32. Money-Kyrle, R.E. (1965) Success and failure in mental maturations, in The Collected Papers of Roger Money-Kyrle first published in 1978 by Strath Tay: Clunie Press. —— (1968) Cognitive development, International Journal of Psycho-Analysis, 49: 691–8. Nacht, S. (1962) Curative factors in psychoanalysis, International Journal of Psycho-Analysis, 43: 206–11. O’Shaughnessy, E. (1999) Relating to the superego, International Journal of Psycho-Analysis, 80: 5. Riesenberg Malcolm, R. (1999) The mirror: a perverse sexual phantasy seen in a woman as a defence against psychotic breakdown, in Bearing Unbearable States of Mind. London: Routledge. Rosenfeld, H. (1947) Analysis of a schizophrenic state with depersonalization, International Journal of Psycho-Analysis, 28: 130–9. —— (1952) Notes on the psycho-analysis of the super-ego conflict of an acute schizophrenic patient, International Journal of Psycho-Analysis, 33: 111–31. —— (1964) An investigation into the need of neurotic and psychotic patients to act out during analysis, in Psychotic States. New York: International Universities Press, 1966: 200–16. —— (1971) A clinical approach to the psychoanalytic theory of the life and death instincts: an investigation into the aggressive aspects of narcissism, International Journal of Psycho-Analysis, 52: 169–78. —— (1987) Impasse and Interpretation, London: Routledge. Segal, H. (1950) Some aspects of the analysis of a schizophrenic, in The Work of Hanna Segal, 1986. London: Free Association Books. —— (1952) A psycho-analytic contribution to aesthetics, International Journal of Psycho-Analysis, 33: 196–207. —— (1954) A note on schizoid mechanisms underlying phobia formation, International Journal of Psycho-Analysis, 35: 238–41. —— (1956) Depression in the schizophrenic, International Journal of PsychoAnalysis, 37: 339–43. —— (1957) Notes on symbol formation, International Journal of PsychoAnalysis, 38: 391–7. —— (1964) Introduction to the Work of Melanie Klein. London: Hogarth Press. Reprinted in 1988 by Karnac Books. —— (1972) The role of child analysis in the general psychoanalytic training, International Journal of Psycho-Analysis, 53: 157–61. 269

Bibliography —— (1974) Delusion and artistic creativity: some reflections on reading The Spire by William Golding, International Review of Psycho-Analysis, 1: 135–41. —— (1976) Bulletin of British Psychoanalytical Society, No. 4. —— (1978) On symbolism, International Journal of Psycho-Analysis, 59: 315–19. —— (1979) Melanie Klein. London: Fontana.. —— (1981a) The Work of Hanna Segal (collected papers). New York: Jason Aronson. Reprinted in 1986 by Karnac Books. —— (1981b) The function of dreams, in Do I Dare Disturb the Universe? A Memorial to Wilfrid R. Bion, edited by James S. Grotstein. California: Caesura Press. —— (1983) Some clinical implications of Melanie Klein’s work — emergence from narcissism, International Journal of Psycho-Analysis, 64: 269–76. —— (1984) Joseph Conrad and the mid-life crisis, International Review of Psycho-Analysis, 11: 3–9. —— (1985) The Klein-Bion model, in Models of the Mind:Their Relationships to Clinical Work, edited by A. Rothstein. New York: International Universities Press. —— (1987) Silence is the real crime.This paper was first given in Hamburg in 1985, in the wake of the IPA Congress, at the inaugural meeting of the International Psychoanalysts Against Nuclear Weapons and published in 1987 in the International Review of Psycho-Analysis, 14: 3–12. The postscript was added in 2002 and the whole published in Terrorism and War: Unconscious Dynamics of Political Violence, edited by C. Covington, P.Williams, J.Arundale and J. Knox. London: Karnac Books. —— (1990a) Dream, Phantasy and Art. London: Routledge. —— (1990b) What is an object? The role of perception, Psychoanalysis in Europe, Bulletin, 35,Autumn. —— (1990c) Hanna Segal interviewed by Jacqueline Rose, Women: A Cultural Review, 1(2): 198–214. —— (1990d) Special Issue of Psychoanalytic Inquiry on Corrective Emotional Experience. —— (1992a) Acting on phantasy and acting on desire, Psychoanalysis, Mind and Art: Perspectives on Richard Wollheim, edited by J. Hopkins and A. Savile. Oxford: Basil Blackwell. —— (1992b) Model of mental functioning and psychoanalytic process, Journal of the American Psychoanalytic Association, 40: 801–26. —— (1995) From Hiroshima to the Gulf War and after: socio-political expressions of ambivalence, in Psychoanalysis in Contexts: Paths between 270

Bibliography Theory and Modern Culture, edited by A. Elliot and S. Frosch. London: Routledge. —— (1996a) Klein, in Dictionnaire International de la Psychanalyse, edited by A. de Mijolla. Paris: Hachette. —— (1996b) Symbolic equation and symbols, in Dictionnaire International de la Psychanalyse, edited by A. de Mijolla. Paris: Hachette. —— (1996c) Bion’s alpha function and alpha elements, in Dictionnaire International de la Psychanalyse, edited by A. de Mijolla. Paris: Hachette. —— (1998) Hanna Segal interviewed by Dorrit Harazim, Veja, 31(16). —— (2000) Review of ‘Le Génie Feminin Tome II – Melanie Klein’ by Julia Kristeva. International Journal of Psycho-Analysis, 82(2): 401–5. —— (2001a) Interpretation des rèves cent ans après, Journal de la Psychanalyse de L’Enfant, 28, translated by Francis Drossart. —— (2001b) Symposium on Terror, Trauma, Revenge and Repair: Reactions to September 11 2001 and its Aftermath. University College London, 4 November 2001. —— (2002) IPA Newsletter, II(I). —— (2006) Reflections on truth, tradition, and the psychoanalytic tradition of truth, American Imago, 63(3): 283–92. Segal, H., Rosenfeld, H. and Bion,W.R. (1961) Melanie Klein, International Journal of Psycho-Analysis, 42: 4–8. Sodré, I. (2004) Who’s who? Notes on pathological identifications, in In Pursuit of Psychic Change. London: Routledge. Steiner, J. (1982) Perverse relationships between parts of the self: a clinical illustration, International Journal of Psycho-Analysis, 63: 241–51. —— (1987) The interplay between pathological organizations and the paranoid-schizoid and depressive positions, International Journal of PsychoAnalysis, 68: 69–80. Strachey, J. (1934) The nature of the therapeutic action of psychoanalysis, International Journal of Psycho-Analysis,15: 127–59. Tennyson,A. (c. 1880) Charge of the light brigade, in The Collected Poems of Alfred Lord Tennyson,Ware, Hertfordshire:Wordsworth Editions, 1994. Winnicott, D.W. (1951) Transitional objects and transitional phenomena, in Collected Papers of D.W.Winnicott, 1958. London:Tavistock. —— (1953) Transitional objects and transitional phenomena – a study of the first not-me possession, International Journal of Psycho-Analysis, 34: 89–97. —— (1954–5) The depressive position in normal emotional development, in Collected Papers of D.W.Winnicott:Through Paediatrics to Psycho-Analysis, 1958. London:Tavistock. —— (1956) Primary maternal preoccupation, in Collected Papers of 271

Bibliography D.W. Winnicott: Through Paediatrics to Psycho-Analysis,1958. London: Tavistock. —— (1960) Ego distortion in terms of true and false self, in The Maturational Processes and the Facilitating Environment (1965). London: Hogarth Press. —— (1971) Playing and Reality. London:Tavistock. Wollheim, R. (1971) Freud. London: Fontana. —— (1979) The cabinet of Dr Lacan, New York Review of Books, 25 January. —— (1984) The Thread of Life. Cambridge, MA: Harvard University Press. —— (1993) Crime, punishment, and ‘pale criminality’, in The Mind and its Depths. Cambridge, MA: Harvard University Press.

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Name index

Abraham, K. 49, 187, 213 Alighieri, D. 29 Arendt, H. 262 Arfort, F. 197 Alexander, F. 159

205; and transference/ counter-transference 76, 207, 217; transformations in O 76 Blum, H. 139 Brenner, C. 92 Britton, R. 193, 230–4

Birksted-Breen, D. 193 Bion,W.R. 51, 54, 75–7, 95, 135, 176, 187, 194, 201–23, 264; and alpha/beta elements 17, 55, 75, 90, 113, 139, 207, 219–21; and alpha function 56, 75, 207, 221–3; and analysis with Klein 194; and attacks on linking 205; and attitude of analyst 208; and beta-screen 216–17; and bizarre objects 59, 204, 214; and contact barrier 87, 216, 220; and container/contained 16, 86, 125, 127, 153, 192, 207, 215; and groups 39, 197, 242, 244–5; and ‘K’ link 208, 215; and ‘nameless dread’ 207; and phantasy 115, 207; and preconceptions 115, 118, 205; and projective identification 214, 221; and repression 216, 220; and reverie 153, 192, 208, 223; and ‘thinking’

Chomsky, N. 115 Cegli, di G. 127 Einstein,A. IV4p15 Etchegoyen, H. 139 Fairbairn,W.R.D. 51, 238 Ferenczi, S. 75, 159, 195 Fornari, F. 41, 197 Freud,A. 51, 74, 165, 178–9, 238 Freud, S. 46–8, 56, 95, 102, 135, 159, 176, 206, 208, 211, 213, 247, 252; and death and life instincts 89, 93, 178, 183; and dreams 14–18, 47; and groups 38; and infantile sexuality 180; and models of the mind 70–2, 84, 90; and phantasy 98, 115; and primary narcissism 193; and projection 183; and reality principle 60, 97, 106; and

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Name index repression 76, 87, 108, 112, 216; and sexual abuse 245; and superego 47, 93; and symbolism 181; and the structural model 49, 72, 84, 93, 178; and transference 76; and the unconscious 70, 132

85, 99, 183–184; and phantasy 115; and play technique 72, 175, 178; and projective identification 16, 73, 99, 184, 206, 213, 221; and relation to Bion 196; and relation to Lacan 195; and relation to Segal 239; and relation to Winnicott 195; and repression 17, 86; and sublimation 181; and the superego 85; and transference 140; and unconscious phantasy 99, 213 Klauber, J. 201, 227 Kristeva, J. 189–98 Kuhn,T.S. 73

Garcia Marquez, G. 37 Glover, E. 247 Grosskurth, P. 190, 249 Heimann, P. 163, 194, 196, 239 Hug-Hellmuth, von, H. 178 Hume, D. 209 Isaacs, S 99, 115, 181, 194, 242

Lacan 192, 239, 249–50 Langer, M. 242 Laufer, M. 175, 243 Lobo,A. 261

Jackson, J. 65 Joffe,W. 201, 227 Jones, E. 17, 54, 181, 240, 247 Kant, E. 209, 212 Keats, J. 209 Kernberg, O. 139 King, P. 74 Kestenberg, J. 244 Klein, M. 51, 72–3, 90, 94, 139, 166, 175–198, 213, 251, 255, 264; and death instinct 190, 197; and depressive position 16, 50, 73, 86, 107, 124, 182, 185–6, 212, 256; and envy 30; and epistemophilic instinct 27, 62, 180, 208, 215; and feminism 247; and infantile aggression 182; and infant sexuality 247; and life and death instincts (in conflict) 182; and narcissism 231; and object relationships 49; and paranoid-schizoid position 73,

Masson, J. 245 Milton, J. 26, 29 Money-Kyrle, R. 48, 50, 52, 109, 115, 118, 197, 218 Nacht, S. 151, 153 Origenes 29 O’Shaughnessy, E. 19, 218 Pichon Riviere, H. 61 Plato 212 Reisenberg Malcolm, J. 64, 124–9 Riviere, J. 194 Rodriquez, E. 243 Rosenfeld, H. 51, 54, 77, 135, 139, 187, 194, 218, 230–3, 264 Rustin, M. and M. 197

274

Name index Sach, H. 159 Shakespeare,W. 59, 232 Sodré, I. 127 Spillius, E. Bott 241 Steiner, J. 87, 232 Steiner, R. 74, 240 Strachey, J. 49, 51, 140 Tennyson,A. 44

Thorner, H. 194 Vianna, H.B. 261 Weinshel, E. 139 Winnicott, D. 176, 192–3, 195, 215, 227 Wittgenstein, L. 213 Wollheim, R. 96, 126, 195

275

Subject index

acting in 21, 141–2 acting out 48, 97, 112, 153, 157, 161 active techniques 159, 195 alpha elements 17, 75, 139, 219–21 alpha function 75, 127, 214, 221–3 ambivalence 25, 29, 50, 93–4, 107–8, 180, 185 as-if world 107 beta elements 17, 21–22, 58, 75, 87, 207 beta barrier/beta-screen 75, 87, 216–17 bizarre objects 204, 214 borderline patients 18, 57, 101, 154, 188 castration fears 118, 249 child analysis 49, 53, 72, 89, 165–72, 175, 178–82, 240;Anna Freud and 74; infantile aggression 182; play technique 175, 178 childhood memories 140 clinical material 54, 62, 65, 101,

118–24, 125, 128, 141–9, 155–7, 167; child analysis and 167; counter-transference and 58, 162; dreams and 18–23, 28, 35, 57, 63, 90, 116; voyeurism and 62–4, 65–8 concrete thinking 155, 166 container/contained relationship 16, 57–58, 86, 153, 192, 215 contact barrier 17, 87, 216, 220 counter-transference 56–60, 146, 160; and transference 150, 156–7, 164, 217; uses and abuses 163 creativity 166; and the depressive position 73; and symbolism 75 criminal responsibility 100 death instinct 15, 91, 190, 197, 231; conflict with life instincts 30, 93, 182; and envy 184 defence(s) 180; manic and schizoid 41, 74, 185; see also projection, introjection, repression depressive position 49, 54, 73, 86, 107, 128, 182, 256; ambivalence 185; psychic suffering 33, 202; and projective identification; and

277

Subject index shift to paranoid-schizoid position 94; and reparation 186 disintegration/fragmentation 37, 43, 164 disillusionment 25–6 dream(s) 14, see also clinical material analysis of 14–24; dream-thought 221; and psychosis 24

models of the mind 83–91 mother 106, 256–7; alpha function of (containment) 91, 207, 214, 221; body of 180; as idealised object 249; identification with 149; narcissistic union with 150; as part object 102; reverie of 153, 192, 208, 223; and symbolism 192; as whole (separate) object 49, 68, 149 mourning 25 murder 100–2

epistemophilic instinct 27, 52, 62, 126, 180, 191, 208, 215 envy 28–30, 36, 62, 149, 208, 223, 227–8, 231–4, 250

narcissism 139, 193, 230–4, 249; and destructive 194; and envy 229; primary 193, 250 nature vs. nurture 256 nuclear weapons 38

father 192, 250 feminism 247, 251–2 fusion: with analyst 28; with mother 27 genius 189 group processes 38–9, 103, 263; and Bion 39, 197, 242–5; and Freud 38 guilt 33, 41 homosexuality 155, 253–5 idealisation 144 imagination 107 infant observation 171 infant sexuality 248 insight 51, 64, 125, 151, 158 integration 49, 51, 89, 151 internal world 47, 72, 75, 140, 164, 166, 179 introjection 84, 126–7; of container 127; and projection 84, 166, 180, 206 life instinct 89, 91

object: definition of 114; ideal 232; internal 15, 101; lure of 104, 126; part-objects 166; persecutory 119, 233; saturated 122, 127; separate 121; whole-objects 108, 124, 185 object relationships 47, 49, 51, 84–5, 94–5, 160, 193; and narcissism 231; and phantasy 181 Oedipus complex 50, 52, 144, 149, 166, 227, 248; and depressive position 176; Klein’s view of 176, 179, 186; role of curiosity 203 omnipotence 34, 41–2, 60, 99, 104, 117, 127–8, 153, 157, 223, 251, 256, 260 paranoid-schizoid position 49, 52, 54–5, 85, 99, 183–4, 204; shift to depressive

278

Subject index position 128, 139, 213 pathology 50, 55, 63, 74, 87, 89, 100, 166, 232, 256 perception 114–24 persecution 119, 202 perversion 61, 63, 251, 254, 260 phantasy 50, 107; about the analyst 65; acting on/acting out 103; inborn 115; masturbatory 64, 125; omnipotent 106, 221; unconscious 15, 52, 93, 97, 163, 180, 247 pleasure principle 60, 201 primal scene 116, 125, 128 preconceptions 115, 118 projection 47, 62, 166; and beta elements 17; into analyst 19, 141, 153, 161; into groups 43; and introjection 47, 73, 180, 206; withdrawal of 88, 213 projective identification 52, 54, 60, 68, 99, 104–5, 109, 122, 124–9, 141, 164, 184, 203, 206; Bion’s view of 214, 221; and introjection 127; pathological 113, 127, 204, 213; and psychosis 52; and symbol formation 111; withdrawal of 108, 124 Prozac 259, 264 psychoanalysis 130–5; aims 51, 77, 152–4; making mistakes 158; and politics 241–3; of psychotics 188, 204; and setting 48, 152; and technique 48, 154, 162, 170, 208, 218; and therapeutic factors 152, 160, 218; and tradition 69, 264; and training 170 psychic change 83 psychic suffering 201 psychic reality 46, 51, 208 psychosis: delusion 103;

disintegration 34, 112; in groups 103; regression to and emergence from 21–2, 26, 34, 36, 59, 213; and voyeurism 61 reality principle 60, 97, 106, 213 reality testing 106, 251 regression 112, 123, 156 reparation 73, 186 repression 17, 76, 108, 163, 180, 254; as contact barrier 87, 220; excessive 17, 87, 112, 216; and splitting 87 repetition compulsion 101–4, 162 resistance 142 reverie 153; of mother 153, 192, 208, 223 self-help books 260 September 11th 37 sexual abuse 245–7, 260 splitting 50, 87, 161, 164, 217 structural model 49, 84, 93 sublimation 54, 112, 166 superego 47, 50, 72, 84–5, 93, 205, 232; persecutory 127, 157, 185, 230; sadistic 179 symbol/symbolism 127, 134, 191 symbolic equation 16, 54, 111–13 symbolic survival 263 symbolisation/symbol formation 47, 52, 54, 166, 180–1, 212; alpha elements 17; in the depressive position 109; and mourning 111; role of father 192 terrorism 40 therapeutic alliance 142, 153 transference 47, 55, 76, 134, 139,

279

Subject index 156, 161, 163; and dreams 19; erotic 105; interplay with countertransference 150, 156–7, 164, 217; total situation 140

voyeurism 61–8, 126, 128, 254 war 37–45, 243, 247, 263; denial in 42

280